FEMA Distribution Center 
NFIP Underwriting and Claims Materials 
Order Form 

800-480-2520 • FAX: 240-699-0525 

Qty. Inv.no./FEMAForMno. tItlE 
UNDERWRITING  
F-050/086-0-1 (8/10)  Flood Insurance Application  
F-051/086-0-3 (8/10)  Flood Insurance General Change Endorsement  
F-052/086-0-2 (8/10)  Flood Insurance Cancellation/ Nullification Request Form  
F-053/81-31 (3/09)  Elevation Certificate and Instructions  
F-056/81-65 (3/09)  Floodproofing Certificate for Non-Residential Structures  
F-086/086-0-4 (8/10)  V-Zone Risk Factor RatingForm and Instructions  
F-089/086-0-5 (8/10)  Flood Insurance Preferred Risk PolicyApplication  

F-200/086-0-24 (7/07) ResidentialBasement 
Floodproofing Certificate  
F-441/441 (7/09)  Insurance Agent’s Lowest Floor Guide  
ORDER FORMS  
F-057  NFIP Public Awareness Materials Order Form  
F-106  NFIP Underwriting and Claims  

MaterialsOrderForm(this form) 
In a hurry? Many of the forms listed above can be downloaded at www.fema.gov/library/index.jsp 
Qty. Inv.no./FEMAForMno. tItlE 
NOTE: As of January 1, 2012, claims forms are available ONLY online at www.fema.gov/help/forms.shtm 
086-0-6/F-098 (10/10)  Worksheet – Contents- 
Personal Property  
086-0-7/F-099 (10/10)  Worksheet – Building  
086-0-8/F-100 (10/10)  Worksheet – Building (cont.)  
086-0-9/F-101 (10/10)  Proof of Loss  
086-0-10/F-554 (10/10)  Increased Cost of Compliance  
Proof of Loss  
086-0-11/F-102 (10/10)  Notice of Loss  
086-0-12/F-103 (10/10)  Statement as to Full Cost of  
Repair or Replacment Cost  
086-0-13/F-093 (10/10)  Preliminary Report  
086-0-14/F-094 (10/10)  Final Report  
086-0-15/F-095 (10/10)  Narrative Report  
086-0-16/F-092 (10/10)  Cause of Loss and  
Subrogation Report  
086-0-17/F-136 (10/10)  Manufactured (Mobile) Home/  
Travel Trailer Worksheet  
086-0-18/F-776 (10/10)  Manufactured (Mobile) Home/  
Travel Trailer Worksheet (cont.)  
086-0-19/F-555 (10/10)  Increased Cost of Compliance  
Adjuster Report  
086-0-20/F-674 (10/10)  Adjuster Preliminary Damage  
Assessment  
086-0-21/F-673 (10/10)  Adjuster Certification Application  

Please print or type the following information:  
Name:  
Company:  
Street Address:  
City:  State:  Zip Code:  
Telephone: (  )  Fax: (  )  

to place an order, call 800-480-2520, 8:00 a.m. to 5:00 p.m., ESt, Monday through Friday; or fax to 240-699-0525; or mail to: 
FEMA Publications Warehouse • 4440 Buckeystown Pike • Frederick, MD 21704 
F-106 (3/12)