HMA Cash Advance Request Form

Download the HMA Request for Advancement form (CLICK HERE), complete it. and upload below.

Step 1 of 3

Contact Information
Sub-Recipient Name (Municipality/Entity Name)*
Primary Point of Contact (POC)*
First Last
Primary POC Email*
Enter Email Confirm Email
Primary POC Phone*

Documentation Upload
Please upload the Request for Advancement Form*
Please download, complete, and upload the HMA Request for Advancement form. The form may be downloaded at the top of the page.
Max. file size: 1 GB.
Please upload a Justification Letter on Town/City Letterhead*
On Town/City Letterhead please provide (1) the amount requested for advancement, (2) a brief justification summary for the Town/City's need of an advancement (3) intended use and timeline of the advancement of funds
Drop files here or

Max. file size: 1 GB.
Certification and Submission
The person completing this cash advance request is the same as the Primary POC*
- Yes
- No
Name of Person Completing Request*
First Last
Email of Person Completing Request*
Enter Email Confirm Email
Phone Number of Person Completing Request*
By checking the box below and entering my name, I agree and understand that providing any false information may result in the inability to distribute any further monies or benefits related to this project until a complete and accurate report has been sent to NH HSEM.*
- I understand and agree
By checking the box below and entering my name, I agree and understand that any money granted as a cash advance must be used solely on activities approved by FEMA for this project and listed under the project’s scope of work. Additionally, if the project is overvalued or undergoes a scope change that lowers the total federal share of the project cost below the amount given in the cash advance, the entity that received the cash advance must return the excess monies to the State of New Hampshire.*
- I understand and agree
Comments
Provide any additional comments or notes that you would like to share with HSEM regarding this request.
Comments
This field is for validation purposes and should be left unchanged.

HMA Cash Advance Request Form

Step 1 of 3

Contact Information

Project Information

Documentation Upload

Certification and Submission

Quick Links

Upcoming Trainings