View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
1660-0005
ICR Reference No:
200706-1660-006
Status:
Historical Active
Previous ICR Reference No:
200402-1660-004
Agency/Subagency:
DHS/FEMA
Agency Tracking No:
Title:
National Flood Insurance Program Claims Forms
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/20/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/28/2007
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2010
36 Months From Approved
09/30/2007
Responses
42,225
0
27,970
Time Burden (Hours)
29,448
0
20,134
Cost Burden (Dollars)
0
0
0
Abstract:
The Claims Forms used for the National Flood Insurance Program are used by policyholders and adjusters to collect the information needed to investigate, document, evaluate, and settle claims against National Flood Insurance Program policies for flood damage to their insured property or qualification for benefits under Increased Cost of Compliance coverage.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
72 FR 19943
04/20/2007
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 34031
06/20/2007
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
16
IC Title
Form No.
Form Name
Adjuster Certification Application 81-110
81-110
Adjuster Certification Application
Adjuster Preliminary Damage Assessment 81-109
81-109
Adjuster Preliminary Damage Assessment
Cause of Loss and Subrogation Report 81-63
81-63
Cause of Loss and Subrogation Report
Increase of Compliance Proof of Loss 81-42A
81-42A
Increase Of Compliance Proof of Loss
Increased Cost of Compliance (ICC) Adjuster Report 81-98
81-98
Increased Cost of Compliance Adjuster Report
Mobile Home Worksheet
81-96
Mobile Home Worksheet
Mobile Home Worksheet Con'td 81-96A
81.96 A
NFIP Mobile Home Worksheet cont.
NFIP Final Report 81-58
81-58
NFIP Final Report
NFIP Narrative Report 81-59
81-59
NFIP Narrative Report
NFIP Preliminary Report 81-57
81-57
NFIP Preliminary Report
NFIP Statement of Full Cost or Replacement 81-44
81-44
NFIP Statement of Full Cost or Replacement
NFIP Worksheet - Building 81-41
81-41
NFIP Building Worksheet
NFIP Worksheet Building 81-41A
81-41A
NFIP Worksheet Building
Notice of Loss 81-43
81-43
Notice of Loss
Proof of Loss 81-42
81-42
Proof of Loss
Worksheet Contents Personal Property
81-40
Worksheet Contents Personal Property
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
42,225
27,970
0
0
14,255
0
Annual Time Burden (Hours)
29,448
20,134
0
0
9,314
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$9,000,853
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Aubrey Flynt 202 646-2624 aubrey.flynt@dhs.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
06/28/2007
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