Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Statement as to Full Cost of Repair or Replacement under the Replacement Cost Coverage, Subject to the Terms and Conditions of this Policy Modified 1040 104 0 Form 086-0-12
Adjuster Certification Application Modified 520 130 0 Form 086-0-21
Adjuster Preliminary Damage Assessment Modified 520 130 0 Form 086-0-20
Cause of Loss and Subrogation Report Modified 364 364 0 Form 086-0-16
Increase of Compliance Proof of Loss Modified 260 520 0 Form 086-0-10
Increased Cost of Compliance (ICC) Adjuster Report Modified 260 109 0 Form 086-0-19
Manufactured (Mobile) Home/Travel Trailer Worksheet Modified 208 104 0 Form 086-0-17
Manufactured (Mobile) Home/Travel Trailer Worksheet (Continued) Modified 208 52 0 Form 086-0-18
National Flood Insurance Program Final Report Modified 3640 255 0 Form 086-0-14
National Flood Insurance Program Narrative Report Modified 2080 166 0 Form 086-0-15
National Flood Insurance Program Preliminary Report Modified 3640 255 0 Form 086-0-13
National Flood Insurance Program Worksheet - Contents - Personal Property Modified 2184 5460 0 Form 086-0-06
Notice of Loss Modified 3640 255 0 Form 086-0-11
Proof of Loss Modified 3640 291 0 Form 086-0-9
Worksheet - Building Modified 3640 9100 0 Form 086-0-07
Worksheet - Building (Continued) Modified 3640 3640 0 Form 086-0-08
Total burden requested under this ICR: 29484 20935 0  
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