Coastal Structures (Form 5)

Revision to National Flood Insurance Program Maps: Application Forms and Instructions for LOMRs and CLOMRs

Documents and Forms

Document Name Document Type
Instructions for Completing the Application Forms for CLOMR & LOMR.pdf www.fema.gov/plan/prevent/fhm/frm_form.shtm Instruction
FEMA Form FF-206-F Coastal Structures (Form 5) FEMA Form FF-206-FY-21-104_DRAFT.pdf www.fema.gov/library/viewRecord.do?id=1493 Form

Information Collection (IC) Details

IC Title:	Coastal Structures (Form 5)	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 Part 65 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Instructions for Completing the Application Forms for CLOMR & LOMR.pdf	http://www.fema.gov/plan/prevent/fhm/frm_form.shtm	No		Printable Only
Form	FEMA Form FF-206-FY-21-104 (formerly 086-0-27D)	Coastal Structures (Form 5)	FEMA Form FF-206-FY-21-104_DRAFT.pdf	http://www.fema.gov/library/viewRecord.do?id=1493	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	-55	65
Annual IC Time Burden (Hours)	70	-385	455
Annual IC Cost Burden (Dollars)	0	-325,000	325,000

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.