Form 81-64 (Individual and Community Preparedness Plan) is a questionnaire designed by FEMA to help individuals and communities assess their preparedness for disasters. The questionnaire covers a wide range of topics, from emergency planning and evacuation procedures to insurance coverage and contact information. Completing the form can help you evaluate your current level of preparedness and identify any areas where you may need to improve. It's also a good idea to update your Form 81-64 annually, or whenever there are significant changes in your personal or community situation. Ready.gov has a step-by-step guide on how to complete the form, which you can find here: https://www.fema.gov/media-library/assets/documents/16394
| Question | Answer |
|---|---|
| Form Name | Fema Form 81 64 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | fema form 81 64, E-MAIL, SW, CID |
DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
APPLICATION FOR PARTICIPATION IN THE NATIONAL FLOOD
INSURANCE PROGRAM
O.M.B. NO.
Expires February 29, 2008
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this form is estimated to average 4 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required to submit to this collection of information unless a valid OMB control number appears in the upper right corner of 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, 500 C Street SW, Washington, DC 20472, Paperwork Reduction Project
1. APPLICANT COMMUNITY NAME (City, town, etc.)
DATE
COUNTY, STATE
2. COMMUNITY OFFICIAL - CHIEF EXECUTIVE OFFICER (CEO)
TELEPHONE NO. (Include area code)
ADDRESS (Street or box no., city , state, zip code)
3.PROGRAM COORDINATOR (Official, if different from above, with overall responsibility for implementing program)
TELEPHONE NO. (Include area code)
ADDRESS (Street or box no., city , state, zip code)
4.LOCATION OF COMMUNITY REPOSITORY FOR PUBLIC INSPECTION OF NFIP MAPS
ADDRESS
5.ESTIMATES FOR THOSE AREAS PRONE TO FLOOD AND/OR MUDSLIDE AS OF THE DATE OF THIS APPLICATION
AREA IN ACRES
POPULATION
NO. OF
FAMILY
STRUCTURES
NO. OF ALL
OTHER
STRUCTURES
6. ESTIMATES OF TOTALS IN ENTIRE COMMUNITY
POPULATION
NO. OF
FAMILY
STRUCTURES
NO. OF ALL
OTHER
STRUCTURES
7. FOR FEMA REGIONAL OFFICE USE ONLY
1. FEMA REGIONAL OFFICE
2. NAME OF CONTACT
3. TELEPHONE NO.
4. LEVEL OF 44 CFR 60.3 REGULATION ADOPTED (Check one)
60.3(a) |
|
60.3(b) |
|
60.3(c) |
|
60.3(d) |
|
60.3(e) |
5.CHECK APPROPRIATE BOX:
EMERGENCY PHASE
REGULAR PHASE
IF REGULAR PROGRAM, SPECIFY FIRM INDEX DATE. IF USING ANOTHER COMMUNITY'S FIRM, GIVE COMMUNITY NAME, CID, FIRM INDEX DATE AND MAP PANEL NUMBER DEPICTING COMMUNITY.
FEMA Form |
REPLACES ALL PREVIOUS EDITIONS |