Information Collection

Flood Insurance Application

IC 43970 under ICR 201611-1660-004 · OMB 1660-0006.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

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 086-0-1	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: 29,550

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 18 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	29,550	24,220	5,330
Annual IC Time Burden (Hours)	5,910	4,844	1,066
Annual IC Cost Burden (Dollars)	0	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.