<b>BUSINESS ONLY</b><br> If caller is completing an application for business losses only, use the name of the business owner or representative, not the business name.<br><br><b>
FUNERAL ONLY</b><br> If caller is completing a registration for funeral expenses only, use the name of the person responsible for the funeral expenses of the deceased person to complete this registration.<br><br><b>
CHILD CARE ONLY</b><br>If you are completing an application for child care only, enter the physical location affected by the disaster that caused new or additional child care cost or disaster related loss of income for the household, such as child care facility, place of employment.<br><br><b>
FILING A REGISTRATION FOR SOMEONE OTHER THAN THE CALLER</b><br> In unique situations where the disaster victim is unable to register themselves, FEMA accepts registration information from the individual's representative providing the representative has all pertinent information. <br><br> If the caller will be helping the applicant throughout the disaster recovery process, please inform them that a notarized release of information document allowing them access to the file will be needed. <br><br><b>
PREFIX</b><br> Click on the drop-down list button and select one of the two available options: <b>MR</b> or <b>MS</b>. The appropriate title is necessary to properly address correspondence. <br><br><b>
APPLICANT FIRST NAME</b><br> Enter the first name in this field. Do not include the name of the co-applicant in this field. DO NOT use ANY type of accent marks in the name field as this will slow the processing of the registration. This field accepts a maximum of 50 alphabetic characters.<br><br><b>
APPLICANT MIDDLE INITIAL</b><br>Enter the middle initial if available.<br><br><b>
APPLICANT LAST NAME</b><br> Enter the last name in this field. If appropriate, enter JR, SR, III, etc., following the last name, such as "JONES JR" or "JONES III." DO NOT use ANY type of accent marks in the name field as this will slow the processing of the registration. This field accepts a maximum of 50 alphabetic characters. <br><br><b><I>
APPLICANT SOCIAL SECURITY NUMBER</b><br>A SSN is required to register, if the caller does not have a SSN <i>see Applying on behalf of Dependent Child).</i><br><br><b>
<ul><li>Applying on behalf of Dependent Child</b><br> If the caller does not have a SSN but does have a dependent child in the household with a SSN, enter that child's SSN and all of the child's information in the registrant's fields for this screen.</li>
<li><b>Business ONLY</b><br> If this registration is for business losses ONLY, enter the SSN of the responsible party for the business. This information will be used as an identifier only.</li>
<li><b>Funeral ONLY</b><br>Enter the social security number of the person responsible for the funeral expenses.</li></ul><br>
<b>E-MAIL ADDRESS</b><br>
Enter e-mail address if available.<br><br><b>
DATE OF BIRTH</b><br>
Enter the date of birth in the MM/DD/YYYY format. (Example: 01/01/1960)
