FEMA Form FF-206-F Residential Basement Floodproofing Certificate

DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency

OMB No.: 1660-0033
Expiration: 06/30/2024

National Flood Insurance Program

RESIDENTIAL BASEMENT FLOODPROOFING CERTIFICATE
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 2.5 hours per response. The burden estimate includes the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
submitting this Residential Basement Floodproofing Certificate. You are not required to respond to this collection of information
unless a valid OMB control number is displayed in the upper right corner of this Residential Basement Floodproofing Certificate.
Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information
Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW,
Washington, DC 20472, Paperwork Reduction Project (1660-0033). NOTE: Do not send your completed form to this address.

PRIVACY ACT STATEMENT
AUTHORITY: National Flood Insurance Act of 1968, as amended (42 U.S.C. § 4001 et seq.).

DRAFT

PRINCIPAL PURPOSE(S): This information is being collected for two primary purposes: (1) For community use in documenting
compliance with floodplain management ordinances, where records are maintained by the community, and (2) For flood insurance
purposes of estimating the risk premium necessary to provide flood insurance for new or substantially improved structures in
designated Special Flood Hazard Areas.
ROUTINE USE(S): When this form is maintained by FEMA and is used in conjunction with the application and maintenance of a
flood insurance policy, the information requested on this form may be shared externally as a “routine use” to authorized WYO
companies receiving transferred policies, to assist the Department of Homeland Security (DHS)/FEMA in estimating the risk
premium rates necessary to provide flood insurance for new or substantially improved structures in designated Special Flood Hazard
Areas. A complete list of the routine uses can be found in the system of records notice associated with this form, “DHS/FEMA-003 National Flood Insurance Program Files 79 Fed. Reg. 28,747 (May 19, 2014); and upon written request, written consent, by
agreement, or as required by law. The Department's full list of system of records notices can be found on the Department's website
at http://www.dhs.gov/system-records-notices-sorns.
DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may
result in the inability to obtain flood insurance through the National Flood Insurance Program, or the building being subject to higher
premium rates for flood insurance. Information will only be released as permitted by law.

PURPOSE OF THE RESIDENTIAL BASEMENT FLOODPROOFING CERTIFICATE
The National Flood Insurance Program requires that all new construction and substantial improvements of residential structures
within SFHA Zones A1-30, AE, AH, and AO have the lowest floor, including the basement, elevated to or above the base flood level
unless an exception is granted.
In only those approved communities that have been granted an exception (List of Approved Communities for Residential Basement
Floodproofing Premium Discount (fema.gov), a registered professional engineer or architect, licensed in the State where the building
is located, must complete this form to certify that the building’s structural design is floodproof.
If the certification is granted, the residential structure is eligible for a lower flood insurance premium based on the lowest floor of the
building.

FEMA Form FF-206-FY-21-122 (12/23)

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PROPERTY INFORMATION

Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

FOR INSURANCE
COMPANY USE
Policy Number:

City:

Company NAIC Number:

Building Owner's Name:

State:

ZIP Code:

Property Description (e.g., Lot and Block Numbers, or Legal Description) and/or Tax Parcel Number:
Building Use (e.g., Non-Residential, Mixed Use, Addition, Accessory, etc.):
Latitude/Longitude: Lat.
Horizontal Datum:

Long.
NAD 1983

NAD 1927

WGS 84

SECTION I - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
NFIP Community Name:

NFIP Community Identification Number:

County Name:

State:

Map/Panel Number:

Suffix:

DRAFT

FIRM Index Date:

FIRM Panel Effective/Revised Date:

Flood Zone(s):

BFE(s) (Zone AO, use Base Flood Depth (BFD)):

Indicate the source of the BFE data or BFD entered above:
Community Determined

Flood Insurance Study (FIS)

FIRM

Other:

Indicate elevation datum used for BFE shown above:

NGVD 1929

Other/Source:

NAVD 1988

SECTION II - FLOODPROOFED ELEVATION CERTIFICATION
(By a Registered Professional Engineer or Architect Licensed in the State Where the Building is Located)
ALL ELEVATIONS MUST BE BASED ON FINISHED CONSTRUCTION
Floodproofing Elevation Information for Zones A1-30, AE, AH, AO:

Building is floodproofed to an elevation of
.
feet. (In Puerto Rico only:
(Elevation datum used must be the same as that on the FIRM)
Elevation of the top of the basement floor is

.

feet.

.

(In Puerto Rico only:

meters.)

.

meters.)

Lowest adjacent (finished) grade next to the building (LAG):

.

feet.

(In Puerto Rico only:

.

meters.)

Highest adjacent (finished) grade next to the building (HAG):

.

feet.

(In Puerto Rico only:

.

meters.)

Indicate elevation datum used for Section II:

NGVD 1929

NAVD 1988

Other/Source:

(NOTE: For insurance rating purposes, the building's floodproofed elevation must be at least 1 foot above the Base Flood Elevation to receive rating
credit. If the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher premium.)

Section II certification is to be signed and sealed by an engineer or architect licensed in the State where the building is
located 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):

Title:

Company Name:

Mailing Address:
City:
Phone #1:

State:
Ext.:

ZIP Code:

Phone #2:

Ext.:
Place Seal Here

Email:

Signature:
FEMA Form FF-206-FY-21-122 (12/23)

Date:
Page 2 of 4

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
City:

State:

FOR INSURANCE COMPANY USE
Policy Number:

ZIP Code:

Company NAIC Number:

SECTION II - FLOODPROOFED ELEVATION CERTIFICATION (Continued)
(By a Registered Professional Engineer or Architect Licensed in a State Where the Building is Located)
Comments (including source of conversion factor and description of any attachments):

SECTION III - CONSTRUCTION CERTIFICATION
(By a Registered Professional Engineer or Architect Licensed in the State Where the Building is Located)

DRAFT

Residential Floodproofed Basement Construction Certification:

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.
• Basement area, together with attendant utilities and sanitary facilities, is watertight to the floodproofing design elevation with
walls that are impermeable to the passage of water without human intervention; and
• Basement walls and floor are capable of resisting hydrostatic and hydrodynamic loads and the effects of buoyancy resulting
from flooding to the floodproofing design elevation; and have been designed so that minimal damage will occur from floods
that exceed the floodproofing design elevation; and
• Building design, including the floodproofing design elevation, complies with community requirements; and

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

Title:

Company Name:

Mailing Address:
City:
Phone #1:

State:
Ext.:

ZIP Code:

Phone #2:

Ext.:
Place Seal Here

Email:

Signature:

Date:

Comments (including source of conversion factor and description of any attachments):

Copies of this certificate must be given to: 1) the community official: 2) the insurance agent: and 3) the building owner.
FEMA Form FF-206-FY-21-122 (12/23)

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INSTRUCTIONS FOR COMPLETING THE RESIDENTIAL BASEMENT
FLOODPROOFING CERTIFICATE AND REQUIRED DOCUMENTATION
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 a residential basement floodproofing
rating discount. Approved communities are listed on the FEMA website at Residential Buildings with Basements| FEMA.gov (see
List of Approved Communities for Residential Basement Floodproofing Premium Discount (fema.gov).
Required Documentation:
a. Photographs of all sides of the building
b. Photographs of any penetration (Utilities, Mechanical)
c. Flood insurance application

DRAFT
FEMA Form FF-206-FY-21-122 (12/23)

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