U.S. DEPARTMENT OF HOMELAND SECURITY 
FEDERAL EMERGENCY MANAGEMENT AGENCY 
National Flood Insurance Program 

OMB No. 1660-0008 
Expiration Date: July 31, 2015 

FLOODPROOFING CERTIFICATE 
FOR NON-RESIDENTIAL STRUCTURES

The floodproofing of non-residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a floodproofing design certification is required. This form is to be used for that certification. Floodproofing of a residential building does not alter a community’s floodplain management elevation requirements or affect the insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. 


FOR INSURANCE COMPANY USE 
POLICY NUMBER
COMPANY NAIC NUMBER


BUILDING OWNER’S NAME 
STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER 
OTHER DESCRIPTION (Lot and Block Numbers, etc.) 
CITY STATE ZIP CODE 


SECTION I – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 
Provide the following from the proper FIRM: 

COMMUNITY NUMBER PANEL NUMBER SUFFIX DATE OF FIRM INDEX FIRM ZONE BASE FLOOD ELEVATION 
(In AO Zones, Use Depth) 

Indicate elevation datum used for Base Flood Elevation shown above: 
NGVD 1929 
NAVD 1988 
Other/Source: 

SECTION II – FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) 

Elevations are based on: 
Construction Drawings 
Building Under Construction 
Finished Construction 

Floodproofing Design Elevation Information: 
Building is floodproofed to an elevation of . feet (In Puerto Rico only: . meters). 
NGVD 1929 
NAVD 1988 
Other/Source: 
(Elevation datum used must be the same as that used for the Base Flood Elevation.) 

Height of floodproofing on the building above the lowest adjacent grade is feet (In Puerto Rico only: meters). 

For Unnumbered A Zones Only: 
Highest adjacent (finished) grade next to the building (HAG) . feet (In Puerto Rico only: . meters) 
NGVD 1929 
NAVD 1988 
Other/Source: 

(NOTE: For insurance rating purposes, the building’s floodproofed design elevation must be at least 1 foot above the Base Flood Elevation to receive rating credit. If the building is floodproofed only to the Base Flood Elevation, then the building’s insurance rating will result in a higher premium.) 


SECTION III – CERTIFICATION (By a Registered Professional Engineer or Architect) 

Non-Residential Floodproofed Construction Certification: 

I certify that, based upon development and/or review of structural design, specifications, and plans for construction, the design and methods of construction are in accordance with accepted standards of practice for meeting the following provisions: 

The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. 

All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. 

I certify that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable 
by fine or imprisonment under 18 U.S. Code, Section 1001. 

CERTIFIER’S NAME LICENSE NUMBER (or Affix Seal) 
TITLE 
COMPANY NAME 
ADDRESS 
CITY 
STATE 
ZIP CODE 
SIGNATURE 
DATE 
PHONE 

Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner. 

FEMA Form 086-0-34 (7/12)  REPLACES ALL PREVIOUS EDITIONS F-056



National Flood Insurance Program 

FLOODPROOFING CERTIFICATE 

FOR NON-RESIDENTIAL STRUCTURES 

Paperwork Reduction Act Notice 

General: This information is provided pursuant to Public Law 96-511 (the Paperwork Reduction Act of 1980, as amended), dated December 11, 1980, to allow the public to participate more fully and meaningfully in the Federal paperwork review process. 

Authority: Public Law 96-511, amended; 44 U.S.C. 3507; and 5 CFR 1320. 

Paperwork Burden Disclosure Notice: Public reporting burden for this data collection is estimated to average 3.25 hours 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 this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. 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, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0008). NOTE: Do not send your completed form 
to this address. 

Privacy Act Statement 

Authority: Title 44 CFR § 61.7 and 61.8. 

Principal Purpose(s): This information is being collected for the primary purpose of estimate the risk premium rates necessary to provide flood insurance for new or substantially improved structures in designated Special Flood Hazard Areas. 

Routine Use(s): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by the routine uses published in DHS/FEMA-003 – National Flood Insurance Program Files System or Records Notice 73 Fed. Reg. 77747 (December 19, 2008); DHS/FEMA/NFIP/LOMA-1 – National Flood Insurance Program (NFIP) Letter of Map Amendment (LOMA) System of Records Notice 71 Fed. Reg. 7990 (February 15, 2006); and upon written request, written consent, by agreement, or as required by law. 

Disclosure: The disclosure of information on this form is voluntary; however, failure to provide the information requested may result in the inability to obtain flood insurance through the National Flood Insurance Program or may be subject to higher premium rates for flood insurance. Information will only be released as permitted by law. 

FEMA Form 086-0-34 (7/12) F-056