Information Collection

Adjuster Certification Application

IC 180864 under ICR 201007-1660-006 · OMB 1660-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0005 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 086-0-21 Adjuster Certification Application	Form
086-0-21 Adjuster Certification Application 086-0-21.pdf	Form

IC Title:

Adjuster Certification Application

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	086-0-21	Adjuster Certification Application	086-0-21.pdf		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title: National Flood Insurance Program

FR Citation: 73 FR 77747

Number of Respondents: 520

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 81 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	520	-230	750
Annual IC Time Burden (Hours)	130	-58	188
Annual IC Cost Burden (Dollars)	0	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.