Information Collection

Proof of Loss 81-42

IC 180847 under ICR 200706-1660-006 · OMB 1660-0005.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1660-0005 can be found here:

Documents and Forms

Document Name Document Type
Form 81-42 Proof of Loss 81-42 Form
81-42 Proof of Loss 81-42.pdf www.fema.gov/business/nfip/forms.shtm Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Proof of Loss 81-42	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	81-42	Proof of Loss	81-42.pdf	www.fema.gov/business/nfip/forms.shtm	Yes	No	Fillable Printable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	5,250	5,250
Annual IC Time Burden (Hours)	420	420
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.