If you have not applied for disaster assistance yet, please apply online first. This form is not valid until you have an application on record.

If you have applied and are asked to complete a Declaration and Release Form (OMB form 009-0-3; PDF, 172 KB), there are three ways to submit it:

  1. Download and e-sign the form on your computer or mobile device. Then upload the signed form through the Upload Center in your online account. (You can use Adobe Reader – desktop or mobile app – to save and e-sign the form.)

    In the upload screen:

    • For Assistance Type select Other/Miscellaneous.
    • For Document Type select Citizen Declaration/Release Authorization.


Print the e-signed form or a blank form to fill out. Submit the completed form using one of the methods below:

  1. Fax the form to: 1-800-827-8112.
  2. Mail the form to:

    FEMA – Individuals & Households Program
    National Processing Service Center
    P.O. Box 10055
    Hyattsville, MD 20782-8055

If you need help filling out the form, please call the FEMA Disaster Assistance Helpline, 7 a.m. to 1 a.m. ET, 7 days a week:

  • 1-800-621-3362 (also for 711 & VRS)
  • TTY 1-800-462-7585
  • If you use a relay service, such as video relay service (VRS), captioned phone, or other, please give FEMA the number for that service.

You don’t have to provide the requested information. It’s voluntary. But if you choose not to provide it, FEMA may delay or deny assistance.

Last Updated: 10/27/2021