FEDERAL EMERGENCY MANAGEMENT AGENCY 
MAP SERVICE CENTER ORDER FORM 
For Flood Maps, Flood Insurance Studies, and Subscriptions 
Business Type: Please check the title that corresponds with your business type. 
A1 - FEMA 
(business type, a 1, fema, check if applicable) Unchecked
A2 - FEMA Contractor 
(business type, a 2, fema contractor, check if applicable) Unchecked
A3 - Federal Government 
(business type, a 3, federal government, check if applicable) Unchecked
A4 - State Government 
(business type, a 4, state government, check if applicable) Unchecked
A5 - Local Government 
(business type, a 5, local government, check if applicable) Unchecked
B - Appraiser 
(business type, b, appraiser, check if applicable) Unchecked
C - Insurance 
(business type, c, insurance, check if applicable) Unchecked
D - Individual 
(business type, d, individual, check if applicable) Unchecked
F - Engineer 
(business type, f, engineer, check if applicable) Unchecked
G - Lender 
(business type, g, lender, check if applicable) Unchecked
I - WYO 
(business type, i, w y o, check if applicable) Unchecked
J - Real Estate 
(business type, j, real estate, check if applicable) Unchecked
K - Builder/Developer 
(business type, k, builder and or developer, check if applicable) Unchecked
L - Surveyor 
(business type, l, surveyor, check if applicable) Unchecked
Z1 - Flood Determination 
(business type, z 1, flood determination, check if applicable) Unchecked
Z2 - Title Co. 
(business type, z 2, title company, check if applicable) Unchecked
Z3 - Law Firm/Settlement Co. 
(business type, z 3, law firm and or settlement company, check if applicable) Unchecked
Z4 - Architectural Firm 
(business type, z 4, architectural firm, check if applicable) Unchecked
Z5 - Consulting Firm 
(business type, z 5, consulting firm, check if applicable) Unchecked
Z6 - Other: 
(business type, z 6, other, check if applicable) Unchecked
(other) 
NAME 
(name) 
MAP SERVICE CENTER ACCOUNT NUMBER 
(map service center account number) 
ORGANIZATION 
(organization) 
STREET ADDRESS 
(street address) 
CITY 
(city) 
STATE 
(state) 
ZIP CODE 
(zip code) 
TELEPHONE NUMBER 
(telephone number) 
FAX NUMBER 
(fax number) 
Paper Flood Maps: Each map panel cost $2.00 including index maps. Shipping costs are $.37 per panel for the first 10 panels plus $.03 for each 
additional panel. 
ID/Panel No. 
(paper flood maps, row 1, i d and or panel number) 
Community, County/State 
(paper flood maps, row 1, community, county and or state) 
Qty 
(paper flood maps, row 1, quantity) 
Price/Panel 
X $2.00 = 
Cost 
(paper flood maps, row 1, cost is quantity multiplied by 2 dollars plus applicable shipping costs) 
(paper flood maps, row 2, i d and or panel number) 
(paper flood maps, row 2, community, county and or state) 
(paper flood maps, row 2, quantity) 
X $2.00 = 
(paper flood maps, row 2, cost is quantity multiplied by 2 dollars plus applicable shipping costs) 
(paper flood maps, row 3, i d and or panel number) 
(paper flood maps, row 3, community, county and or state) 
(paper flood maps, row 3, quantity) 
X $2.00 = 
(paper flood maps, row 3, cost is quantity multiplied by 2 dollars plus applicable shipping costs) 
Digital Flood Maps on CD: Each map panel cost $1.50. Shipping costs are $3.65 for the first 4 CDs plus $0.10 for each additional CD. 
ID/Panel No. 
(digital flood maps on c d, row 1, i d and or panel number) 
Community, County/State 
(digital flood maps on c d, row 1, community, county and or state) 
Qty 
(digital flood maps on c d, row 1, quantity) 
Price/Panel 
X $1.50 = 
Cost 
(digital flood maps on c d, row 1, cost is quantity multiplied by 1 dollar 50 cents plus applicable shipping costs) 
(digital flood maps on c d, row 2, i d and or panel number) 
(digital flood maps on c d, row 2, community, county and or state) 
(digital flood maps on c d, row 2, quantity) 
X $1.50 = 
(digital flood maps on c d, row 2, cost is quantity multiplied by 1 dollar 50 cents plus applicable shipping costs) 
(digital flood maps on c d, row 3, i d and or panel number) 
(digital flood maps on c d, row 3, community, county and or state) 
(digital flood maps on c d, row 3, quantity) 
X $1.50 = 
(digital flood maps on c d, row 3, cost is quantity multiplied by 1 dollar 50 cents plus applicable shipping costs) 
Paper Flood Insurance Studies/Floodway Maps (FIS): Each (FIS) cost $5.00 per study volume plus an additional $2.00 for each Floodway map. 
FIS are available as sets only. Shipping costs are $4.00 for the first FIS plus $.40 for each additional FIS and $.37 per panel for the first 10 floodway 
panels plus $.03for each additional panel. 
Community ID No. 
(paper f i s floodway maps, row 1, community i d number) 
Community, County/State 
(paper f i s floodway maps, row 1, community, county and or state) 
Qty Volume 
(paper f i s floodway maps, row 1, quantity volume) 
Qty Panel 
(paper f i s floodway maps, row 1, quantity panel) 
Total Cost 
(paper f i s floodway maps, row 1, total cost is quantity of volumes multiplied by 5 dollars plus quantity of panels multiplied by 2 dollars plus applicable shipping costs) 
(paper f i s floodway maps, row 2, community i d number) 
(paper f i s floodway maps, row 2, community, county and or state) 
(paper f i s floodway maps, row 2, quantity volume) 
(paper f i s floodway maps, row 2, quantity panel) 
(paper f i s floodway maps, row 2, total cost is quantity of volumes multiplied by 5 dollars plus quantity of panels multiplied by 2 dollars plus applicable shipping costs) 
Digital Flood Insurance Studies/Floodway Maps (FIS): $4.00 per study plus $1.50 per floodway. Shipping costs are $3.65 for the first 4 CDs plus 
$0.10 for each additional CD. 
Community ID No. 
(digital f i s floodway maps, row 1, community i d number) 
Community, County/State 
(digital f i s floodway maps, row 1, community, county and or state) 
Qty Volume 
(digital f i s floodway maps, row 1, quantity volume) 
Qty Panel 
(digital f i s floodway maps, row 1, quantity panel) 
Total Cost 
(digital f i s floodway maps, row 1, total cost is quantity of volumes multiplied by 4 dollars plus quantity of panels multiplied by 1 dollar 50 cents plus applicable shipping costs) 
(digital f i s floodway maps, row 2, community i d number) 
(digital f i s floodway maps, row 2, community, county and or state) 
(digital f i s floodway maps, row 2, quantity volume) 
(digital f i s floodway maps, row 2, quantity panel) 
(digital f i s floodway maps, row 2, total cost is quantity of volumes multiplied by 4 dollars plus quantity of panels multiplied by 1 dollar 50 cents plus applicable shipping costs) 
Q3 - Digitized Flood Date Information on CD ROMs: Each CD ROM is $50. Shipping costs are $3.65 for the first four (4) CD-ROMs plus $.10 
for each additional CD-ROM. 
States 
(q 3 digitized flood date information on c d roms, states) 
Quantity 
(q 3 digitized flood date information on c d roms, quantity) 
Price/CD 
X $50 = 
Cost 
(q 3 digitized flood date information on c d roms, cost is quantity multiplied by 50 dollars plus applicable shipping costs) 
CBRA - Q3 CD ROMs : CD ROMs are $50 each or all 5 CDs for $200. Shipping cost is the same as the Q3 above. 
States 
(c b r a, q 3, c d roms, states) 
Quantity 
(c b r a, q 3, c d roms, quantity) 
Price/CD 
X $50 = 
Cost 
(c b r a, q 3, c d roms, cost is quantity multiplied by 50 dollars plus applicable shipping costs) 
One-Time Orders 
Community Status Book : Individual States cost $2.50, entire U.S. cost $20.50. Shipping cost are $1.00 per state, $4.26 for the entire U.S. 
States 
(community status book, row 1, states) 
Quantity 
(community status book, row 1, states, quantity) 
Price/State 
X $2.50 = 
Cost 
(community status book, row 1, states, cost is quantity multiplied by 2 dollars 50 cents plus applicable shipping costs) 
(community status book, row 2, entire united states) 
(community status book, row 2, entire united states, quantity) 
X $20.50 = 
(community status book, row 2, entire united states, cost is quantity multiplied by 20 dollars 50 cents plus applicable shipping costs) 


FEMA Form 81-52A, DEC 02 REPLACES ALL PREVIOUS EDITIONS. 
One-Time Orders (continued) 
Flood Map Status Information Service (FMSIS) : Individual States cost $13.00, entire U.S. cost $38.00. Shipping costs are $3.65 for the first 
four (4) CD-ROMs plus $.10 for each additional CD-ROM. 
States 
(flood map information service, row 1, states) 
Quantity 
(flood map information service, row 1, states, quantity) 
Price/State 
X $13.00 = 
Cost 
(flood map information service, row 1, states, cost is quantity multiplied by 13 dollars plus applicable shipping costs) 
(flood map information service, row 2, entire united states) 
(flood map information service, row 2, entire united states, quantity) 
X $38.00 = 
(flood map information service, row 2, entire united states, cost is quantity multiplied by 38 dollars plus applicable shipping costs) 
Subscriptions 
Community Status Book 
States 
(community status book subscription, row 1, states) 
Quantity 
(community status book subscription, row 1, states, quantity) 
Price/State 
X $50 = 
Cost 
(community status book subscription, row 1, states, cost is quantity multiplied by 50 dollars) 
(community status book subscription, row 2, entire united states) 
(community status book subscription, row 2, entire united states, quantity) 
All U.S. $250 = 
(community status book subscription, row 2, entire united states, cost is quantity multiplied by 250 dollars) 
NFIP Insurance Manual 
Complete Manual 
Quantity 
(n f i p insurance manual, complete manual, quantity) 
Price Per 
X $25.00 = 
Cost 
(n f i p insurance manual, complete manual, cost is quantity multiplied by 25 dollars) 
Producer's Edition 
(n f i p insurance manual, producer's edition, quantity) 
X $15.00 = 
(n f i p insurance manual, producer's edition, cost is quantity multiplied by 15 dollars) 
Flood Map Status Information Service (FMSIS) 
States 
(flood map status information service, row 1, states) 
Quantity 
(flood map status information service, row 1, states, quantity) 
Price/State 
X $148 = 
Cost 
(flood map status information service, row 1, cost is quantity multiplied by 148 dollars) 
(flood map status information service, row 2, entire united states) 
(flood map status information service, row 2, entire united states, quantity ) 
All U.S. $419 = 
(flood map status information service, row 2, entire united states, cost is quantity multiplied by 419 dollars) 
Letter of Map Change Distribution Service (LOMC) 
(letter of map change distribution service) 
Quantity 
(letter of map change distribution service, quantity) 
Price Per 
X $2,000 = 
Cost 
(letter of map change distribution service, cost is quantity multiplied by 2000 dollars) 
Shipping costs are included in the subscription cost. 
Subscription Sub Total: = 
(shipping costs are included in the subscription cost, subscription sub total) 
Order Sub Total: = 
(order sub total) 
Shipping Cost: $ 
(shipping cost) 
Total Cost for Order: $ 
(total cost of order) 
Orders paid by check can be mailed to: FEMA/NFIPMap Service Center 
PO Box 3617 
Oakton, VA 22124  
All other orders can be faxed to: 1-800-358-9620 
Payment Information: 
Check or money order payable to NFIP is enclosed $ 
(payment information, check or money order payable to n f i p is enclosed, check if applicable) Unchecked
(amount of check or money order) 
. 
Charge my 
(payment information, charge my credit card, check if applicable) Unchecked
MC 
(charge my, check if applicable: master card) Unchecked
Visa 
(charge my, check if applicable: visa) Unchecked
Amer. Express 
(charge my, check if applicable: american express) Unchecked
Account No. 
(credit card account number) 
$ 
(amount charged to credit card) 
Expiration Date: 
(credit card expiration date) 
Signature: 
(signature of card holder (Click to sign)) Signature field is unsigned
Charge my deposit account number 
(payment information, charge my deposit account number, check if applicable) Unchecked
(deposit account number being charged) 
$ 
(amount charged to deposit account number) 
. 
(If you would like assistance in calculating the cost of your order or information about setting up a depositaccount, call Customer Service at 1-800-358-9616). All map sales are final - no refunds on material shipped.
Overpayment of less than three dollars ($3.00) is not subject to refund. Visit us online at http://msc.fema.gov 
Thank you for your order.