Drafted Privacy Act Statement

PRIVACY
AUTHORITY: The
1968, as amended;

STATEMENT

44 V.S.c. 3101; National Flood Insurance
1, et
Act of 1973,42

of

PRINCIPAL PURPOSE(S): This infonnation is being collected for the primary purpose of
detennining eligibility and administration community's participation in
FEMA's National
Flood Insurance Program.
ROUTINE USE(S): The infonnation on this fonn may be disclosed as generally pennitted
under 5 U.S.C. § 552a(b) the Privacy
of 1974, as amended. This
infonnation as
and authorized by the routine uses published
003
National Flood
Program
System Records
2008, 73 FR 77747)
and upon written request, by
or as
by law.
DISCLOSURE: The
of
on this
is voluntary; however, failure to
provide the infonnation requested may
or prevent the community
participation in
National Flood Insurance Program.