View Information Collection Request (ICR) Package

OMB Control No: 1660-0006	ICR Reference No: 202103-1660-001
Status: Historical Active	Previous ICR Reference No: 201611-1660-004
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: National Flood Insurance Program Policy Forms
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/16/2021
	Date Received in OIRA: 04/15/2021
Terms of Clearance: Approved for 3 years with the requirement that FEMA revise the information collection package to remove the temporary forms and update burden estimates once FEMA has fully transitioned to the revised methodology.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2024	36 Months From Approved
Responses	409,781	0	0
Time Burden (Hours)	62,196	0	0
Cost Burden (Dollars)	0	0	0

Abstract: In order to provide for the availability of policies for flood insurance, policies are marketed through the facilities of licensed insurance agents or brokers in the various States. Applications from agents or brokers are forwarded to FEMA. Upon receipt and examination of the application and required premium, FEMA issues the appropriate Federal flood insurance policy.

Authorizing Statute(s): PL: Pub.L. 90 - 448 1301 Name of Law: Housing and Urban Development Act of 1968
PL: Pub.L. 93 - 234 6500 Name of Law: Flood Disaster Protection Act of 1973

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:
	85 FR 81481	12/16/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 17615	04/05/2021
Did the Agency receive public comments on this ICR? No

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	409,781	409,771	-601,057	601,067
Annual Time Burden (Hours)	62,196	62,131	-90,950	91,015
Annual Cost Burden (Dollars)	0	-6,500	0	6,500

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: FEMA Form 086-0-1 (Application) – The decrease in burden hours is due to a change in the number of forms submitted. The number of submitted forms reported has decreased from 29,550 to 17,593. The number of burden hours has decreased from 5,910 to 3,519. There are proposed changes to the information being collected. FEMA Form 086-0-2 (Cancellation) – The decrease in burden hours is due to a change in the number of forms submitted. The number of submitted forms reported has decreased from 40,890 to 30,964. The number of burden hours has increased from 5,111 to 3,871. However, there are proposed formatting changes to the form. FEMA Form 086-0-3 (Endorsement) – The decrease in burden hours is due to a change in the number of forms submitted. The number of submitted forms reported has decreased from 510,402 to 323,865. The number of burden hours has decreased from 76,560 to 48,580. There are no changes to the information being collected. FEMA Form 086-0-4 (V-Zone Risk Factor Rating Form) – This form is being eliminated because our system of record shows no instances of active policies using this form. The number of forms submitted has decreased to 0. The number of burden hours has decreased from 65 to 0. FEMA Form 086-0-5 (Preferred Risk Application) – The increase in burden hours is due a change in the number of forms submitted. The number of submitted forms reported has increased from 20,215 to 37,259. The number of burden hours has increased from 3,370 to 6,210.

Annual Cost to Federal Government: $9,360,407

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Millicent Brown 202 646-2814 millicent.brown@fema.dhs.gov

View ICR - OIRA Conclusion