Flood Insurance Preferred Risk Policy Application

National Flood Insurance Program Policy Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0006 can be found here:

Documents and Forms

Document Name Document Type
Form FEMA Form 086-0-5 Flood Insurance Preferred Risk Policy Application Form
FEMA Form 086-0-5 Flood Insurance Preferred Risk Application FEMA Form 086-0-5 06252013.pdf www.nfipservices.com Form

Information Collection (IC) Details

IC Title:	Flood Insurance Preferred Risk Policy Application	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 61

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FEMA Form 086-0-5	Flood Insurance Preferred Risk Application	FEMA Form 086-0-5 06252013.pdf	http://www.nfipservices.com	Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: National Flood Insurance Program Files System of Records	FR Citation: 73 FR 77747

Number of Respondents: 3,662	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 18 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,662	0	2,572	1,090
Annual IC Time Burden (Hours)	612	467	0	145
Annual IC Cost Burden (Dollars)	0	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.