Skip Maine state header navigation

Agencies | Online Services | Help

Skip First Level Navigation | Skip All Navigation

MAINE EMERGENCY MANAGEMENT AGENCY

Get Notified!

Weather, MEMA News, Upcoming Events By Email or Text Message.

Already subscribed? "Follow the button" to change or delete subscriptions.


Frequently Used Forms

Here are the most commonly requested EMA forms. If you have a suggestion for another form that should be listed here, please contact us.

 

EMA Forms
Name Description pdf rtf other
2013 EMPG Sample Local Letter of Application 2013 Sample letter for local jurisdictions to use to apply for EMPG funds. 302275-pdf 302275-rtf 302275-doc
2013 EMPG Local/Partner Budget Worksheet 2013 Local/Partner Agency EMPG Budget Worksheet (Excel format): Use this worksheet to create and submit local budget for the Emergency Management Performance Grant (EMPG) 428373-xls
2013 EMPG Local/Partner Program Guidance 2013 guidance for use of EMPG funds to enhance local and partner emergency management capacity 62251-pdf
2013 Local EMPG Fact Sheet 2013 Fact Sheet about the Emergency Management Performance Grant (EMPG) program 428363-pdf 428363-rtf
2013 EMPG Local SAMPLE work plan SAMPLE work plan for local or partner agency consideration for the EMPG program. Jurisdictions or organizations should modify to fit their programs and priorities. 128277-pdf 128277-rtf 128277-doc
1: HMGP Application Form Application form for 2013 Hazard Mitigation Grant Program funds. Application must contain this page, as well as Attachments 1A, 2A, 2B-1 through -4, 2C, 2D, 3A, 4A, 4B, 4C, 5, 7A, 7B, 8A and 8B. rev. 04/2013. 57622-doc
Supervisor's Report of Injury Form to be completed by Supervisor or Team Chief in case of injury by a Special Teams member. See Special Teams Guidance for Worker's Compensation and Liability 516530-doc
FEMA Form 90-126 Contract Work Summary Use this Public Assistance Form to record contract work costs 67503-pdf
Maine CEM Application Brochure This brochure includes a form to order a Membership Application to become a Maine Certified Emergency Manager (CEM-ME) 53154-pdf
County EMA Work Plan Reporting Guidance Guidelines for Counties to use in preparing quarterly work plan progress reports. 312080-pdf
2012-13 EMPG Local and Partner Billing Sheet Use this spreadsheet to create a cover sheet for loca and partner agency EMPG billings. County EMAs may also use this for special project EMPG billings. 326654-xls
SERC Facility letter Letter sent to facilities describing filing and fee reports for hazardous materials inventories. Also used by Homeland Security grant applicants to review requirements. 318010-Annual SERC Letter.doc
County EMA Staff Training/Exercise Tracking Form Form to track FEMA-requested staff training and exercise information. 312081-xls
EMPG Job Aid: Documenting In-Kind Match FEMA’s Emergency Management Performance Grant (EMPG) allows the use of in-kind resources as a match for grant funds. This job aid is provided to assist in identifying and documenting in-kind match for EMPG. 224710-pdf 224710-rtf
EAS Activation Request Form Use this form to request State level activation of the Emergency Alert System (EAS). 145584-pdf 145584-doc
Small Project Summary Certification Form Use this form to certify to completion of Public Assistance small projects 98530-pdf 98530-doc
Request for Public Assistance (RPA) Form 90-049 58595-pdf
Suspicious Substance Protocol Presentation Training presentation on Suspicious Substance Protocol. 83359-pdf 83359-ppt
Special Response Team Member Qualification Form Form to be used by Team Chiefs to record team members qualifications. Important for worker's comp and liability issues. 69937-doc
Employee's Report of Injury Form to be completed in case of injury by a Special Teams member. See Special Teams Guidance for Worker's Compensation and Liability 73178-doc
Interoperable Communications Survey Communications Assesment as it pertains to the 5 areas of interoperable communications. Please complete prior to April 1st, 2009. 69037--doc
FEMA Form 90-123 Force Account Labor Summary Use this Public Assistance Form to record personnel costs 67499-pdf 67499-xls
FEMA Form 90-127 Force Account Equipment Summary Use this Public Assistance Form to record Equipment costs for equipment you own 67500-pdf 67500-xls
FEMA Form 90-124 Materials Summary Record Use this Public Assistance Form to record Materials costs 67501-pdf 67501-xls
FEMA Form 90-125 Rented Equipment Summary Use this Public Assistance Form to record Rented Equipment costs 67502-pdf 67502-xls
FEMA Form 90-128 Applicant's Benefits Calculation Use this Public Assistance Form to record personnel benefit costs 67505-pdf 67505-xls
ICS Form 205 CONOPS Maine ICS Radio Communication Plan adapted to utilize the Maine CONOPS Frequencies 59538-doc
ICS Form 205-A (Optional) Maine This form is used to capture on scene communications. This form augments the ICS Form 205 by including other communication mediums other than radio. 54043-doc
Form 119-25-1 FEMA/MEMA Standard Training Application Use this form to apply for any MEMA or FEMA training course. Previously was Form 75-5. Social Security Numbers no longer required. 28164-pdf
Damage Assessment Form 7: Aroostook County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency 15038-pdf 15038-doc
Damage Assessment Form 7: York County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency 15041-pdf 15041-doc
Damage Assessment Form 7: Androscoggin County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15053-pdf 15053-doc
Damage Assessment Form 7: Cumberland County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15054-pdf 15054-doc
Damage Assessment Form 7: Franklin County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15055-pdf 15055-doc
Damage Assessment Form 7: Knox County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15056-pdf 15056-doc
Damage Assessment Form 7: Hancock County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15057-pdf 15057-doc
Damage Assessment Form 7: Kennebec County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15058-pdf 15058-doc
Damage Assessment Form 7: Lincoln County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15059-pdf 15059-doc
Damage Assessment Form 7: Oxford County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15060-pdf 15060-doc
Damage Assessment Form 7: Piscataquis County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15061-pdf 15061-doc
Damage Assessment Form 7: Penobscot County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15062-pdf 15062-doc
Damage Assessment Form 7: Somerset County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15063-pdf 15063-doc
Damage Assessment Form 7: Sagadahoc County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15064-pdf 15064-doc
Damage Assessment Form 7: Waldo County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15065-pdf 15065-doc
Damage Assessment Form 7: Washington County Standard form used by municipalities to report damages after an emergency to the County Emergency Management Agency. 15066-pdf 15066-doc
Situation Report: County/Local Form to summarize current emergency situation for submission to county (for locals) or state (for counties, if not using WebEOC) 25091-pdf
Request for Assistance Form Form to use in requesting emergency resources from the County (for locals) and State (for counties, if not using WebEOC) 25092-pdf
Damage Assessment Form 7 Instructions Guidance to assist communities in reporting damages via the Form 7 for their county 25090-pdf

 

You will need the free Adobe® Reader to view PDF documents. RTF documents may be opened with any word processing software. Other: DOC: Microsoft Word® or Word® Viewer. XLS: Microsoft Excel® or Excel® Viewer Should you need an alternate form of any document, please contact us.

 

 

 

Last update: 09/11/13