Narrative of Form Changes (FEMA Form 086–0–24)

Narrative of Form Changes

Collection Title: Residential Basement Floodproofing Certification

OMB Control Number: 1660-0033

Collection Instrument: FEMA Form 086-0-24 (Residential Basement Floodproofing Certificate)

Residential Basement Floodproofing Certificate - Changes 2016

Revise the format of the certificate (FEMA Form 086-0-24) to comply with the current DHS template requirements.

Page 1 – Title and Notices Page

Move the Title and Form Number along with the Paperwork Reduction Act Notice and the Privacy Act Statement to the first page of the form.

Revision to Paperwork Reduction Act Notice

Revise address – if necessary – to which comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden are to be sent. (The address currently on the form is shown as 1800 South Bell Street in Arlington, Virginia.)

Page 2 – Revisions to the Certificate

Note: If revising the format of the form to comply with DHS requirements results in the certificate being more than a single page, see that a space is provided to enter the property address in full at the top of each additional page of the certification.

Revisions to SECTION II

1. Revise the Section II heading to read as follows.

Section II - Floodproofed Elevation Certification (By a Registered Professional Land Surveyor, Engineer, or Architect)

2. Remove the line: Elevations are based on: __ Construction Drawings   __ Building Under Construction   __ Finished Construction

And replace with the line:  All elevations must be based on finished construction.

3. Remove the word “Design” from the heading “Floodproofing Design Elevation Information”, so that it just reads “Floodproofing Elevation Information:”.

4. Add a certification section at the end of SECTION II as follows:

Residential Floodproofed Elevation Information Certification: Section II certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Section II on this Certificate represents a true and accurate interpretation and determination by the undersigned using the available information and data. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME	LICENSE NUMBER (or Affix Seal)
					PLACE SEAL HERE
TITLE	COMPANY NAME
ADDRESS	CITY	STATE	ZIP CODE
SIGNATURE	DATE	PHONE

Revisions to SECTION III

1. Revise the first portion of the certification statement to read as follows:

I certify the structure, based upon development and/or review of the design, specifications, as-built drawings for construction and physical inspection, has been designed and constructed in accordance with the accepted standards of practice (ASCE 24-05, ASCE 24-14, or their equivalent) and any alterations also meet those standards and the following provisions.

2. Add the following bullet to the end of the bulleted list, making it the forth bullet:

• Soil or fill adjacent to the structure is compacted and protected against erosion and local scour (in accordance with ASCE 24).

Note: The other bullets remains the same.

3. Revise the certification section (after the last/forth bullet) at the end of SECTION III to read:

I certify that the information in Section III on this certificate represents a true and accurate determination by the undersigned using the available information and data. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.

CERTIFIER'S NAME	LICENSE NUMBER (or Affix Seal)			PLACE SEAL HERE
TITLE	COMPANY NAME
ADDRESS	CITY	STATE	ZIP CODE
SIGNATURE	DATE	PHONE

Page 3 – Instructions

Create a new instructions page containing the following text:

Instructions for Completing the Residential Basement Floodproofing Certificate

To receive credit for floodproofing, a completed Residential Basement Floodproofing Certificate is required for residential buildings with basements in  Regular  Program  communities, located in zones A1–A30, AE, AR, AR Dual, AO, AH, and A with BFE.

The communities must have been specifically approved and authorized by FEMA to receive residential basement floodproofing rating credit. Approved communities are listed in the Special Certifications section of the NFIP Flood Insurance Manual, available on the FEMA website at https://www.fema.gov/flood-insurance-manual.

When applying for flood insurance, the following information must be provided with the completed Residential Basement Floodproofing Certificate:

• The Flood Insurance Application

• At least two photographs of the building.

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