Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adjuster Certification Application 81-110 New 750 188 0 Form 81-110 Adjuster Certification Application
Adjuster Preliminary Damage Assessment 81-109 New 750 188 0 Form 81-109 Adjuster Preliminary Damage Assessment
Cause of Loss and Subrogation Report 81-63 New 525 525 0 Form 81-63 Cause of Loss and Subrogation Report
Increase of Compliance Proof of Loss 81-42A New 375 750 0 Form 81-42A Increase Of Compliance Proof of Loss
Increased Cost of Compliance (ICC) Adjuster Report 81-98 New 375 158 0 Form 81-98 Increased Cost of Compliance Adjuster Report
Mobile Home Worksheet New 300 150 0 Form 81-96 Mobile Home Worksheet
Mobile Home Worksheet Con'td 81-96A New 300 75 0 Form 81.96 A NFIP Mobile Home Worksheet cont.
NFIP Final Report 81-58 New 5250 368 0 Form 81-58 NFIP Final Report
NFIP Narrative Report 81-59 New 3000 240 0 Form 81-59 NFIP Narrative Report
NFIP Preliminary Report 81-57 New 5250 368 0 Form 81-57 NFIP Preliminary Report
NFIP Statement of Full Cost or Replacement 81-44 New 1500 150 0 Form 81-44 NFIP Statement of Full Cost or Replacement
NFIP Worksheet - Building 81-41 New 4950 12375 0 Form 81-41 NFIP Building Worksheet
NFIP Worksheet Building 81-41A New 5250 5250 0 Form 81-41A NFIP Worksheet Building
Notice of Loss 81-43 New 5250 368 0 Form 81-43 Notice of Loss
Proof of Loss 81-42 New 5250 420 0 Form 81-42 Proof of Loss
Worksheet Contents Personal Property Modified 3150 7875 0 Form 81-40 Worksheet Contents Personal Property
Total burden requested under this ICR: 42225 29448 0  
To view an IC, click on IC Title