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⚠️ Notice: This information collection may be referencing outdated material.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
Form FEMA Form 512-0-1 National Flood Insurance Program Agent Referral Questionaire Form and Instruction
FEMA Form 512-0-1 National Flood Insurance Program Agent Referral Question FEMA Form 512-0-1 04042012.pdf www.FloodSmart.gov Form and Instruction

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: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 44 CFR Part 62 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FEMA Form 512-0-1	National Flood Insurance Program Agent Referral Questionnaire	FEMA Form 512-0-1 04042012.pdf	http://www.FloodSmart.gov	Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: National Flood Insurance Program Marketing Files	FR Citation: 73 FR 77793

Number of Respondents: 50,894	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50,894	-22,123	73,017
Annual IC Time Burden (Hours)	2,545	-1,106	3,651
Annual IC Cost Burden (Dollars)	0	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.