National Flood Insurance Program Agent Referral Questionaire

National Flood Insurance Program Call Center and Agent Referral Enrollment Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0059 can be found here:

Documents and Forms

Document Name Document Type
512-1 (2).pdf Other-Script

Information Collection (IC) Details

IC Title:	National Flood Insurance Program Agent Referral Questionaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Script			512-1 (2).pdf		Yes	No	Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 73,017	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	73,017	73,017
Annual IC Time Burden (Hours)	3,651	3,651
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.