Information Collection

Application for Participation in the National Flood Insurance Program (NFIP)

IC 21042 under ICR 201402-1660-006 · OMB 1660-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FEMA Form 086-0-30 Application for Participation in the National Flood Insurance Program (NFIP)	Form
FEMA Form 086-0-30 Application for Participation in the National Flood Insu FEMA FORM 086-0-30, 5-29-2014.pdf www.fema.gov/library/viewRecord.do?id=2557	Form

IC Title:

Application for Participation in the National Flood Insurance Program (NFIP)

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 59.2

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 086-0-30	Application for Participation in the National Flood Insurance Program	FEMA FORM 086-0-30, 5-29-2014.pdf	http://www.fema.gov/library/viewRecord.do?id=2557	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records

Title: DHS/FEMA-003-National Flood Insurance Program Files System of Records

FR Citation: 79 FR 28747

Number of Respondents: 237

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	237	237
Annual IC Time Burden (Hours)	948	948
Annual IC Cost Burden (Dollars)	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.