Adjuster Preliminary Damage Assessment

National Flood Insurance Program Claims Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0005 can be found here:

Documents and Forms

Document Name Document Type
Form 086-0-20 Adjuster Preliminary Damage Assessment Form
086-0-20 Adjuster Preliminary Damage Assessment 086-0-20.pdf www.feam.gov/national-flood-insurance-program/claims-adjuster-forms Form

Information Collection (IC) Details

IC Title:	Adjuster Preliminary Damage Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	086-0-20	Adjuster Preliminary Damage Assessment	086-0-20.pdf	http://www.feam.gov/national-flood-insurance-program/claims-adjuster-forms	Yes	Yes	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title: National Flood Insurance Program	FR Citation: 74 FR 77747

Number of Respondents: 5,906	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 81 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	5,906	5,386	520
Annual IC Time Burden (Hours)	1,477	1,347	130
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.