Flood Insurance 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⚠️ Notice: This information collection may be referencing outdated material.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 086-0-1 Flood Insurance Application Form
FEMA Form 086-0-1 Flood Insurance Application FEMA Form 086-0-1 06252013.pdf www.nfipservices.com Form

Information Collection (IC) Details

IC Title:	Flood Insurance 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 086-0-1	Flood Insurance Application	FEMA Form 086-0-1 06252013.pdf	www.nfipservices.com	Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: Emergency Management Agency-003 National Flood Insurance Program Files System of Reocrds	FR Citation: 73 FR 77747

Number of Respondents: 5,330	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 18 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,330	-529	5,859
Annual IC Time Burden (Hours)	1,066	-106	1,172
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.