Elevation Certificate/Floodproofing Certificate

Forms and Documents

Document Name	Status
Form FEMA Form 086-0-33 Elevation Certificate Form and Instruction	Modified
Form FEMA Form 086-0-34 Floodproofing Certificate Form and Instruction	Modified
Contact Lists PTA FEMA Elevation and Floodproofing Certificates20120215 priv final.pdf Supplementary Document	2015-08-17
DHS-FEMA-NFIP-LOMA-1 SORN.pdf Supplementary Document	2015-08-11
DHS-FEMA-003 SORN.pdf Supplementary Document	2015-08-11
PIA - DHS-ALL-PIA-006.pdf Supplementary Document	2015-08-05
42 USC 4001.pdf Supplementary Document	2015-08-05
30 Day FRN Published 1660-0008.pdf Supplementary Document	2015-08-05
60 Day FRN Published 1660-0008.pdf Supplementary Document	2015-08-05
Narrative of Changes from Last ICR Submission 1660-0008 April 2015.docx Supplementary Document	2015-08-05
Supporting Statement - 1660-0008 - July 31 2015 FINAL.docx Supporting Statement A	2015-08-05
44 CFR Part 61.doc Supplementary Document	2008-12-16

IC Document Collections

IC ID	Document Title	Status
21050	Elevation Certificate Form and Instruction	Modified
187539	Floodproofing Certificate Form and Instruction	Modified

ICR Details

OMB Control No: 1660-0008	ICR Reference No: 201508-1660-001
Status: Historical Active	Previous ICR Reference No: 201203-1660-003
Agency/Subagency: DHS/FEMA	Agency Tracking No:
Title: Elevation Certificate/Floodproofing Certificate
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: 11/17/2015
	Date Received in OIRA: 08/25/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2018	36 Months From Approved	11/30/2015
Responses	9,322	0	6,575
Time Burden (Hours)	34,950	0	24,649
Cost Burden (Dollars)	3,262,700	0	2,301,250

---

Abstract: The Elevation Certificate and Flooodproofing Certificate are used in conjunction with the flood insurance application to rate Post-FIRM building in Special Flood Hazard Areas. Post-FIRM buildings are buildings are constructed after the publication of the initial Flood Insurance Rate Map (FIRM) for the community.

---

Authorizing Statute(s): US Code: 42 USC 4001 Name of Law: Reorganization Plan of No. 3 of 1978
  

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:
	80 FR 30091	05/26/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 45673	07/31/2015
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Elevation Certificate	FEMA Form 086-0-33	Elevation Certificate
Floodproofing Certificate	FEMA Form 086-0-34	Floodproofing Certificate

---

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	9,322	6,575	0	2,747	0	0
Annual Time Burden (Hours)	34,950	24,649	0	10,301	0	0
Annual Cost Burden (Dollars)	3,262,700	2,301,250	0	961,450	0	0

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: No

Burden Reduction Due to:

Short Statement: The burden hour per response for FEMA Form 086-0-33 and FEMA From 086-0-34 has remained the same. However the burden hours for this collection increased from 24,649 to 34,950 hours, an adjustment increase of +10,301 hours. This increase is due to an increase in the number of flood insurance applications being submitted to the NFIP Direct Servicing Agent, which are rated based on elevation data provided on the certificates. Since the Elevation Certificate and Floodproofing Certificate are submitted in conjunction with an application for flood insurance, more applications being submitted results in more Elevation Certificates and Floodproofing Certificates being submitted. The total number of responses for the Elevation Certificate has increased from 6,560 to 9,307 (+2,747 responses). The number of responses for the Floodproofing Certificate has remained that same at 15 responses.

---

Annual Cost to Federal Government: $43,300

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]? 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? Uncollected

---

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: 08/25/2015

---