Information Collection

Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program

IC 21103 under ICR 200706-1660-005 · OMB 1660-0037.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0037 can be found here:

Documents and Forms

Document Name Document Type
Form FF-81-92 Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program Form
FF-81-92 Application Form (English Version) FF 81-92 6.30.07 A. Flynt.pdf www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm Form
81-92A Application Form (Spanish Version) FEMA Form 81-92A Spanish Version June 07.pdf www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FF-81-92	Application Form (English Version)	FF 81-92 6.30.07 A. Flynt.pdf	http://www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Yes	Yes	Fillable Fileable
Form	81-92A	Application Form (Spanish Version)	FEMA Form 81-92A Spanish Version June 07.pdf	http://www.fema.gov/plan/prevent/fhm/dl_mt-ez.shtm	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 26,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	26,400	26,400
Annual IC Time Burden (Hours)	31,680	31,680
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.