Information Collection

Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program

IC 21103 under ICR 200706-1660-005 · OMB 1660-0037.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0037 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FF-81-92 Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program	Form
FF-81-92 Application Form (English Version) FF 81-92 6.30.07 A. Flynt.pdf www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Form
81-92A Application Form (Spanish Version) FEMA Form 81-92A Spanish Version June 07.pdf www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Form

IC Title:

Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FF-81-92	Application Form (English Version)	FF 81-92 6.30.07 A. Flynt.pdf	http://www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Yes	Yes	Fillable Fileable
Form	81-92A	Application Form (Spanish Version)	FEMA Form 81-92A Spanish Version June 07.pdf	http://www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 26,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	26,400	26,400
Annual IC Time Burden (Hours)	31,680	31,680
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.