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National Flood Insurance Program Claims Forms

Find a Claims Form

Adjuster Certification Application

FEMA Form 086-0-21: This form is used to collect information from individuals seeking to become certified flood adjusters.

Adjuster Preliminary Damage Assessment

FEMA Form 086-0-20: This form is used by adjusters to list potentially substantial damaged structures in preparation for possible ICC claims.

Increased Cost of Compliance (ICC) Adjuster Report

FEMA Form 086-0-19: This form is used by adjusters to list the information required to qualify for an ICC claim and documents the mitigation option and cost.

Mobile Home/Travel Trailer Worksheet (Continued)

FEMA Form 086-0-18: This form is a continuation of the Manufactured (Mobile) Home/Travel Trailer Worksheet and is used by the adjuster to record information to determine the replacement cost and actual cash value of a manufactured (mobile) home.

Manufactured (Mobile) Home/Travel Trailer Worksheet

FEMA Form 086-0-17: This form is used by the adjuster to record information to determine the replacement cost and actual cash value of a manufactured (mobile) home.

Cause of Loss and Subrogation Report

FEMA Form 086-0-16: The adjuster uses this form to identify potentially responsible third parties and their actions that may have caused worsened flood damage.

National Flood Insurance Program Narrative Report

FEMA Form 086-0-15: The adjuster uses this form to report additional information not provided in the Preliminary or Final Report as part of documenting the claim.

Adjuster’s Final Report

FEMA Form 086-0-14: This form is used by adjusters to document the overall flood damages to the insured's property and provide a detailed summary of the claims information.

Adjuster’s Preliminary Report

FEMA Form 086-0-13: This form is used by the adjuster to report information to the NFIP Servicing Agent for setting services and initial claims.

Notice of Loss

FEMA Form 086-0-11: This form allows insurance agents or brokers to document damages caused by flood-related hazards to structures covered by NFIP.

Increased Cost of Compliance Proof of Loss

FEMA Form 086-0-10: This form is used by the policyholder to state the amount for an Increased Cost of Compliance claim with sworn details of loss.

Proof of Loss

FEMA Form 086-0-9: A Proof of Loss is a policyholder’s statement of the amount of money being requested.

Worksheet - Building (Continued)

FEMA Form 086-0-8: This form is a continuation sheet used by the adjuster and policyholder to list and assess the amount of building property damage.

Worksheet - Building

FEMA Form 086-0-7: This form is used by adjusters and policyholders to list and assess the scope of flood damaged building property.

Worksheet - Contents: Personal Property

FEMA Form 86-0-6: Adjuster and policyholder use this form to list and assess the inventory of flood-damaged personal property.

Last updated Jul 28, 2020