NOTICE OF LOSS, ADJUSTER'S REPORT: PART 1, PART 2 & PART 3, WORKSHEET - CONTENTS - PERSONAL PROPERTY, WORKSHEET BUILDING, WORKSHEET - BUILDING (CONT'D), PROOF OF LOSS
ICR 198401-3067-001 · OMB 3067-0021 · Historical Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3067-0021 can be found here:
NOTICE OF LOSS, ADJUSTER'S REPORT: PART 1, PART 2 & PART 3, WORKSHEET - CONTENTS - PERSONAL PROPERTY, WORKSHEET BUILDING, WORKSHEET - BUILDING (CONT'D), PROOF OF LOSS
THE FORMS ARE NECESSARY FOR THE CONTINUED PROPER PERFORMANCE OF FEMA'S FUNCTIONS RELATED TO INDEMNIFYING POLICYHOLDERS FOR FLOOD DAMAGES TO THEIR PROPERTIES.
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:
(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;
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.
NOTICE OF LOSS, ADJUSTER'S REPORT: PART 1, PART 2 & PART 3, WORKSHEET - CONTENTS - PERSONAL PROPERTY, WORKSHEET BUILDING, WORKSHEET - BUILDING (CONT'D), PROOF OF LOSS