Information Collection

Agent Referral Program Enrollment Form

IC 21138 under ICR 201206-1660-005 · OMB 1660-0059.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 517-0-1 Agent Referral Program Enrollment Form	Form
FEMA Form 517-0-1 National Flood Insurance Agent Site Registration FEMA Form 517-0-1 04042012.pdf www.FloodSmart.gov	Form
FEMA Form 517-0-1 NFIP Agent Site Registration FEMA Form 517-0-1 (electronic version 6112012.doc www.FloodSmart.gov	Form

IC Title:

Agent Referral Program Enrollment Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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

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	FEMA Form 517-0-1	National Flood Insurance Agent Site Registration	FEMA Form 517-0-1 04042012.pdf	http://www.FloodSmart.gov	Yes	No	Fillable Printable
Form	FEMA Form 517-0-1 (electronc)	NFIP Agent Site Registration	FEMA Form 517-0-1 (electronic version 6112012.doc	http://www.FloodSmart.gov	Yes	Yes	Fillable Fileable

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: 5,751

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,751	-3,028	8,779
Annual IC Time Burden (Hours)	190	-103	293
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.