Sample 1
Notice of Voluntary Interest
Local Government Name 
Floodprone Property Acquisition Project 
Town Hall Meeting 
Homeowner Interest Sign-up Sheet and Voluntary Interest Notice
FEMA requires the local government to inform all prospective participants of the following: 
NOTICE:  Participation in this project for open-space acquisition is voluntary. 
Neither the State nor the Local Government will use its eminent domain authority to 
acquire the property for open-space purposes if you choose not to participate in a 
Hazard Mitigation Assistance grant program, or if negotiations fail.  Signing this 
does not commit you to any action.

Property Address
Owner(s) Mailing 
Address
Owner(s) Name and 
Phone #
Owner(s) Signature
Interested 
Yes or No