Form 086-0-35A NFIP Repetitive Loss Update Worksheet

Property Acquisition and Relocation for Open Space

FEMA FORM 086-0-35A 4-1-2017

CRS Community Certifications (NFIP Repetitive Loss Update Worksheet)

OMB: 1660-0103

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DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency
CRS COMMUNITY CERTIFICATIONS

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Public reporting burden for this form is estimated to average 4 hours for annual recertification, per response. The burden estimate includes the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting
the form. This collection of information is required to obtain voluntary benefits. You are not required to respond to this collection of information
unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency,
500 C Street, S.W., Washington, D.C. 20472, Paperwork Reduction Project (1660-0022). NOTE: Do not send your completed form to this
address.
Appendix E

This appendix contains forms for the community certifications that are part of the documentation needed to obtain credit for certain activities
under the National Flood Insurance Program's Community Rating System (CRS). The certification forms are designed to be used in conjunction
with the CRS Coordinator's Manual.
Two required certifications are not included here. The AW-501 (Repetitive Loss Update Certification) and the AW-501 Transmittal Sheet are
generated separately by the Federal Emergency Management Agency (FEMA) and provided to the community when needed.
The certifications of compliance with environmental and historic preservation requirements can be found in Appendix F.
Contents
• CC-213 Recertification
• CC-230 Verification
• CC-RL The Repetitive Loss List
• CC-530 Retrofitted Buildings
The following community certifications are part of the documentation needed to obtain credit for certain activities under the National Flood
Insurance Program's Community Rating System (CRS). These certifications are designed to be used in conjunction with the CRS Coordinator's
Manual.
Sections in each certification correspond to the same numbered sections in the Coordinator's Manual. If a section appears to be missing, it is
because that section does not call for the submission of a specific item.
It is recommended that these certifications be photocopied before they are used. They are also available in Microsoft Word® and as fillable pdf
files at www.CRSresources.org/200.
The “CID” at the top of each page signifies the six digit National Flood Insurance Program (NFIP) community identification number, which can
be found on the community's Flood Insurance Rate Map and other NFIP documents.

FEMA FORM 086-0-35A (04/17)

Page 1 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-213 Recertification
Date
Chief Executive Officer

CRS Coordinator

Name
Title
Address

Phone number
E-mail address
I hereby certify that

[community name] is implementing the following activities on the attached

pages as credited under the Community Rating System and described in our original application to the CRS and subsequent modifications.
I hereby certify that, to the best of my knowledge and belief, we are in full compliance with the minimum requirements of the NFIP and we
understand that we must remain in full compliance with the minimum requirements of the NFIP. We understand that at any time we are not to
be in full compliance, we will retrograde to a CRS Class 10.
I hereby certify that we will continue to maintain FEMA Elevation Certificates on all new buildings and substantial improvements constructed in
the Special Flood Hazard Area following the date at which we joined the CRS.
I hereby certify that if there are one or more repetitive loss properties in our community that we must take certain actions that include
reviewing and updating the list of repetitive loss properties, mapping repetitive loss areas, describing the cause of the losses, and sending an
outreach project to those areas each year, and if we have fifty (50) or more unmitigated repetitive loss properties we must earn credit under
Activity 510 (Floodplain Management Planning) for either a repetitive loss area analysis (RLAA) or a floodplain management plan (FMP).
I hereby certify that, to the best of my knowledge and belief, we are maintaining in force all flood insurance policies that have been required of
us as a condition of federal financial assistance for insurable buildings owned by us and located in the Special Flood Hazard Area (SFHA)
shown on our Flood Insurance Rate Map. I further understand that disaster assistance for any community-owned building located in the SFHA
is reduced by the amount of National Flood Insurance Program (NFIP) flood insurance coverage (structure and contents) that a community
should be carrying on the building, regardless of whether the community is carrying a policy.

(Chief Executive Officer)

Signature

CC-213-1
FEMA FORM 086-0-35A (04/17)

Page 2 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

B. In a regulated
C. In the rest of the
A. In the SFHA floodplain outside
community
the SFHA

CRS Program Data Table
1. Last report's number of buildings in the SFHA (bSF) (line 6, last report)
2. Number of new buildings constructed since last report

3. Number of buildings removed/demolished since last report

4. Number of buildings affected by map revisions since last report (+ or -)
5. Number of buildings affected by corporate limits changes (+ or -)
6. Current total number of buildings in the SFHA (bSF) (total lines 1-5)
7. Number of substantial improvement/damage projects since last report
8. Number of repetitive loss properties mitigated since last report
9. Number of LOMRs and map revisions (not LOMAs) since last report
10. Acreage of the SFHA (aSFHA) as of the last report (line 13, last report)
11. Acreage of area(s) affected by map revisions since last report (+ or -)
12. Acreage of area(s) affected by corporate limits changes (+ or -)
13. Current acreage of the SFHA (total lines 10−12)
14. Primary source for building data:
15. Primary source for area data:
16. Period covered:

Current FIRM date

If available, the following data would be useful:
17. Number of new manufactured homes installed since last report
18. Number of other new 1 -4 family buildings constructed since last report
19. Number of all other buildings constructed/installed since last report
Comments:
(Please note the number of the line to which the comment refers.)

CC-213-2
FEMA FORM 086-0-35A (04/17)

[continued on next page]
Page 3 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

Instructions
At the first verification visit after the 2013 CRS Coordinator's Manual takes effect, ONLY LINES 6 AND 13 NEED TO BE COMPLETED. These
lines form the baseline data about the number of buildings and area of the SFHA for when the table is completed as part of the next annual
recertification. The "period covered" entered in line 16 is the date that lines 6 and 13 are first completed.
At all subsequent annual recertifications and cycle verification visits, the entire table is completed. The information in lines 6 and 13 from the
last report is transferred to lines 1 and 10 in the next report.

Instructions for the Columns
Column A numbers are for the SFHA (the A and V Zones shown on the Flood Insurance Rate Map) (FIRM)). Use the FIRM currently in effect,
not a draft or pending revision.
Column B is completed only if the community receives CRS credit for regulating floodplain development outside the SFHA under Activity 410
(Floodplain Mapping) or Activity 430 (Higher Regulatory Standards).
Column C numbers help relate what happens in the floodplain to what is happening in the rest of the community.
Enter "0" if there are no numbers to report for this period. Do not leave a cell blank. Do not fill in the shaded boxes.

Instructions for the Lines
Lines 1-7 deal with buildings.
o Section 301.a of the CRS Coordinator's Manual defines what constitutes a "building" and lists examples of structures that are not
counted as "buildings" by the CRS.
o Section 302.a of the CRS Coordinator's Manual describes how the CRS counts buildings. For example, accessory structures are not
counted.
o As noted in Section 302.a, to determine building counts, communities may use any method that yields reasonably good estimates of
the number of buildings. Examples of acceptable methods are listed in Section 302.a. Precision is less important for large numbers. For
example, the impact of the numbers will not change much if there are 10,000 buildings or 10,100 buildings.
o If a building is out of the SFHA, but in a parcel that is partly in the SFHA, it is not counted in column A --In the SFHA.
o In line 14, note how the building counts were obtained or estimated. Use the comments area, if needed.
Line 4 refers to map revisions. These include physical map revisions, Letters of Map Revision (LOMR), and Letters of Map Amendment
(LOMA). If a building is removed from the SFHA by FEMA through a LOMA, but the community still administers its floodplain management
regulations on the property, the building should not be included in the line 4 count in column A --In the SFHA. However, communities that still
regulate areas removed by LOMAs can receive credit under Activities 410 or 430. If the community is receiving such credit, the building
should be counted under column B --In a regulated floodplain outside the SFHA.
Line 7 is for the total number of buildings that were substantially improved plus the number of buildings that were substantially damaged
during the period covered.
Lines 10 -13 deal with areas.
o These areas are based on the areas shown on the community's FIRM including LOMRs or LOMAs. Section 403.b discusses those
portions of the SFHA that are subtracted from the area of the SFHA to calculate the community's aSFHA used in credit calculations.
o Section 403.e of the CRS Coordinator's Manual discusses calculating areas for CRS purposes.
o Section 403.e notes that communities “should not spend an inordinate amount of time measuring areas.” As with buildings,
communities may use any method that yields reasonably good estimates. Examples of acceptable approaches are listed in Section 403.e.
o Line 13 asks for the current acreage of the SFHA. The best source for this number is a GIS layer that shows the SFHA. If the
community does not have GIS, the county, regional agency, or state NFIP mapping office may have SFHA layers and may be able to
provide the data. If the community has a relatively recent FIRM, the study contractor or consulting engineer may have the data.
o In line 15, note how the area calculations were obtained or estimated. Use the comments area, if needed.
Lines 17 -19 are voluntary, if the numbers are readily available.
o Line 17 includes replacing an existing manufactured home with a new one. The newly placed manufactured home is counted as a new,
post-FIRM, building.
o The total of lines 17 -19 should equal the value entered in line 2.
CC-213-3
FEMA FORM 086-0-35A (04/17)

Page 4 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-230 Verification
Date of Visit

Initial FIRM Date

Population

Current FIRM Date

County

ISO/CRS Specialist

Coordinator's Manual Year
Chief Executive Officer

CRS Coordinator

Name
Title
Address

Phone number
E-mail address
I hereby certify that
[community name] is implementing the following activities [check the ones
that apply]. We will continue to implement these activities and will advise FEMA if any of them are not being conducted in accordance with this
certification. We will cooperate with the ISO/CRS Specialist's verification visit and will submit the documentation and annual recertification
needed to validate our program.
310 (Elevation Certificates)

440 (Flood Data Maintenance)

320 (Map Information Service)

450 (Stormwater Management)

330 (Outreach Projects)

(Repetitive Loss Requirements)

340 (Hazard Disclosure)

510 (Floodplain Management Planning)

350 (Flood Protection Information)

520 (Acquisition and Relocation)

360 (Flood Protection Assistance)

530 (Flood Protection)

370 (Flood Insurance Promotion)

540 (Drainage System Maintenance)

410 (Floodplain Mapping)

610 (Flood Warning and Response)

420 (Open Space Preservation)

620 (Levees)

430 (Higher Regulatory Standards)

630 (Dams)

I hereby certify that, to the best of my knowledge and belief, we are in full compliance with the minimum requirements of the NFIP and we
understand that we must remain in full compliance with the minimum requirements of the NFIP. We understand that at any time we are not to
be in full compliance, we will retrograde to a CRS Class 10.
CC-230-1
FEMA FORM 086-0-35A (04/17)

Page 5 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

I hereby certify that we will maintain FEMA Elevation Certificates on all new buildings and substantial improvements constructed in the Special
Flood Hazard Area following the date at which we joined the CRS.
I hereby certify that if there are one or more repetitive loss properties in our community that we must take certain actions that include
reviewing and updating the list of repetitive loss properties, mapping repetitive loss areas, describing the cause of the losses, and sending an
outreach project to those areas each year, and if we have fifty (50) or more repetitive loss properties must also prepare a plan of how it will
address its repetitive flood problem.
I hereby certify that, to the best of my knowledge and belief, we are maintaining in force all flood insurance policies that have been required of
us as a condition of Federal financial assistance for insurable buildings owned by us and located in the Special Flood Hazard Area shown on
our Flood Insurance Rate Map. I further understand that disaster assistance for any community-owned building located in the Special Flood
Hazard Area is reduced by the amount of National Flood Insurance Program flood insurance coverage (structural and contents) that a
community should be carrying on the building, regardless of whether the community is carrying a policy.

(Chief Executive Officer)

Signature

CC-230-2
FEMA FORM 086-0-35A (04/17)

Page 6 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

B. In a regulated
C. In the rest of the
A. In the SFHA floodplain outside
community
the SFHA

CRS Program Data Table
1. Last report's number of buildings in the SFHA (bSF) (line 6, last report)
2. Number of new buildings constructed since last report

3. Number of buildings removed/demolished since last report

4. Number of buildings affected by map revisions since last report (+ or -)
5. Number of buildings affected by corporate limits changes (+ or -)
6. Current total number of buildings in the SFHA (bSF) (total lines 1 -5)
7. Number of substantial improvement/damage projects since last report
8. Number of repetitive loss properties mitigated since last report
9. Number of LOMRs and map revisions (not LOMAs) since last report
10. Acreage of the SFHA (aSFHA) as of the last report (line 13, last report)
11. Acreage of area(s) affected by map revisions since last report (+ or -)
12. Acreage of area(s) affected by corporate limits changes (+ or -)
13. Current acreage of the SFHA (aSFHA) (total lines 10−12)
14. Primary source for building data:
15. Primary source for area data:
16. Period covered:

Current FIRM date

CC-230-3
FEMA FORM 086-0-35A (04/17)

Page 7 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

Page 8 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-RL The Repetitive Loss List
(See Section 501 in the CRS Coordinator's Manual).

We have reviewed the repetitive loss list dated:

, 20

, and [check one]

Attached are updated Repetitive Loss Update Certifications, AW-501; or
There are no changes to FEMA's repetitive loss list.
As the current CRS Coordinator for

[community name], I have examined the repetitive loss

data provided for each of our
[number] assigned repetitive loss properties. For each property in need of update,
I have attached an AW-501 that reflects the current and accurate address, the correct National Flood Insurance Program (NFIP) community
identification number, and all known mitigation actions with the primary source of funding noted. To the best of my knowledge and belief, any
AW-501 not updated and submitted as part of this application has been checked and is not in need of update at this time.
(Community CRS Coordinator)

Signature

To facilitate verification, please provide the names of the CRS Coordinator and local repetitive loss contact person, if other than the CRS
Coordinator
CRS Coordinator

Repetitive Loss Contact

Name
Title
Phone number
Fax number
Address

E-mail address
Comments:

CC-RL-1
FEMA FORM 086-0-35A (04/17)

Page 9 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Federal Emergency Management Agency
National Flood Insurance Program

NFIP REPETITIVE LOSS UPDATE WORKSHEET (AW-501)
THE INFORMATION ON THIS FORM IS BASED ON CLAIMS ON OR BEFORE:
REPETITVE LOSS NUMBER:

Internal use only
NFIP Community Name:

N/A

FRR

CID#:

Local Property Identifier:
Previous Property Address/Community ID#

Current Property Address

Last Claimant:
Insured:

Last Claimant:
Name Insured:

Date of Losses:

Total Number of Losses for Property:

REQUESTED UPDATES
MARK ALL UPDATES BELOW THAT APPLY (IMPORTANT - SEE INSTRUCTIONS)
1.

INFORMATION PROVIDED NOT SUFFICIENT TO IDENTIFY PROPERTY.
Choose this update if all attempts to locate the property fail. Please describe the steps you took to locate the property in the
comments section below.

COSMETIC CHANGES REQUIRED TO THE ADDRESS:
Update the address shown above and/or add our local
alternative property identifier such as a Tax Assessor #.

PROPERTY NOT IN OUR COMMUNITY OR JURISDICTION:
Choose this update if you have positively determined that the property shown is not located in your community. Please provide
the correct NFIP community name and if known the NFIP community ID Number. If available, please attach a map showing the
property location.
ASSIGN TO NFIP COMMUNITY NAME:

NFIP COMMUNITY ID#:

FLOOD PROTECTION PROVIDED.
Choose this update only if some type of structural intervention has occurred to the building, prop-erty or the source of flooding
that protects the building from future events similar to those that occurred in the past. The update must be supported by
documentation such as an Elevation Certifi-cate and the Mitigation action and funding below must be provided.
(Mitigation Action 1.)

(Source of Primary Mitigation Funding 3.)

CC-RL-2 (AW-501-1)
FEMA FORM 086-0-35A (04/17)

(Secondary Source of Funding 3.)

[continued on next page]
Page 10 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

NO BUILDING ON PROPERTY.
Choose this update only if the property in question can be positively identified as the site of the previously flooded building and
documentation is available to support that an insurable building no longer exists at this site. The update must be supported by
documentation such as a Demolition or Relocation Permit and the Mitigation action and funding information below must be
provided.
(Mitigation Action 2.)

(Source of Primary Mitigation Funding 3.)

DUPLICATE LISTING WITH RL NUMBER:

(Secondary Source of Funding 3.)
COMBINE AS ONE LISTING.

Choose this update to identify two or more separate listings that are for the same building. List all other RL numbers that are
duplicates to this property. Please indicate which address shown is the correct address to use.
7.

HISTORIC BUILDING:
Choose this update if you know the building is or would be eligible to be listed on a State or National Historic Registry.

COMMENTS SECTION:

A signed RL transmittal sheet must accompany this form for approval of the update!

CC-RL-3 (AW-501-2)
FEMA FORM 086-0-35A (04/17)

Page 11 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

CC-530 Retrofitted Buildings
This certification is used for retrofitting projects that are not in a high-hazard area and that do not need to be designed or approved by a
registered design professional. Completed FEMA Elevation Certificates are used for buildings retrofitted by elevation (TUE).

Part 1. For Credit Calculations Option 1 and Option 2
Part 1 is used for all submissions for credit under TUD, TUW, TUS, and TUB.
I certify that, for the buildings on the attached list,
All retrofitting projects were completed after the effective date of our initial FIRM:
[Date];
All retrofitting projects provide protection to at least the 25-year flood level;
All required permits were issued for each project, or the project complies with all federal, state, and local codes and regulations;
None of the retrofitting projects was mandated by the substantial improvement or substantial damage requirements of our
floodplain management regulations; and
All retrofitting projects are currently in good condition.

Part 2. For Credit Calculation Option 2
Part 2 is needed only if the community is requesting credit under Section 533.b. Option 2 for buildings submitted for credit under TUD, TUW,
and TUS.
One copy of this certification can be used for multiple properties that have the same score.
Dry floodproofed buildings (TUD)
The buildings listed as property numbers
have been dry floodproofed and [check one]
The project was designed by a registered design professional and the design accounts for openings, internal drainage,
seepage, and underdrainage. (TU = 0.6)
The project does not depend on human intervention to close openings; the project protects to a level less than 3 feet over the
first floor; the design accounts for internal drainage, seepage, and underdrainage; and the building does not have a basement
(i.e., any floor below grade on all sides). (TU = 0.4)

There is no documentation of how openings, interior drainage, seepage, or underdrainage are handled. (TU = 0.2)

CC-530-1
FEMA FORM 086-0-35A (04/17)

[continued on next page]
Page 12 of 13

OMB Control Number: 1660-0022
Expiration: 3/31/2020

Community

State

CID
(6-digit NFIP Community Identification Number)

Wet floodproofed buildings (TUW)
The buildings listed as property numbers
have been wet floodproofed and [check one]
The project was designed by a registered design professional. (TU = 0.5)
The project was not designed by a registered design professional. (TU = 0.3)
The furnace, water heater, electrical breaker box, and other utilities are relocated above flood level. (TU = 0.2)
Buildings protected from sewer or sump backup (TUS)
The buildings listed as property numbers

, which

have been protected from sewer or sump backup and [check one]
The building is located in the SFHA. (TU = 0.2)
The building is located outside of the SFHA and the community has a building code or other regulations that require positive
drain sewers or other measures that prevent sewer backup into new buildings. (TU = 0.1)

Name (printed)

Title

Signature

Date

CC-530-2
FEMA FORM 086-0-35A (04/17)

Page 13 of 13

File Type	application/pdf
File Title	FEMA Form
File Modified	2017-04-12
File Created	2017-04-03