Flood Zone Disclosure Checklist

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Property Identification

1 of 8

Basic information about the property being disclosed.

Property Address

Parcel Number/Tax ID

Legal Description (brief)

Lot Size (acres)

Date of Disclosure

Seller's Name(s)

Buyer's Name(s)

Flood Zone Determination

2 of 8

Details regarding the property's flood zone designation as determined by FEMA.

FEMA Flood Zone Designation:

FEMA Map ID (e.g., Panel Number):

Community Name:

Source of Flood Zone Information (e.g., FEMA Map, Community Floodplain Administrator, etc.):

Date of Flood Zone Determination (or Date of Most Recent Map Update):

Copy of Flood Map Extract (if available):

Is the Property Located within a Community Participating in the National Flood Insurance Program (NFIP)?

Flood Hazard History

3 of 8

Information about past flooding events impacting the property.

Has the property ever experienced flooding?

If yes, please describe the dates, severity, and impact of any past flooding events.

Approximate depth of flooding (in feet) during the most recent flooding event (if applicable).

Date of the most recent flooding event (if applicable).

Were any repairs or remediation efforts made following the most recent flooding event? Please describe.

Photos or documentation related to past flooding or repairs (optional).

Has the property ever been declared a disaster area due to flooding?

Insurance Requirements & Costs

4 of 8

Details about flood insurance requirements and potential costs.

Is flood insurance required by the lender?

Estimated annual flood insurance premium (if applicable)

Explanation of how the insurance premium was calculated (e.g., source, year)

Flood Insurance Coverage Type (if applicable)

Building Coverage Amount (if applicable)

Contents Coverage Amount (if applicable)

Any known reasons for premium increase or decrease (e.g., changes in community rating)

Elevation Certificate (if applicable)

5 of 8

Information related to the availability and review of an elevation certificate.

Does an Elevation Certificate exist for this property?

Upload Existing Elevation Certificate (if available)

Summary of Elevation Certificate Findings (if available)

Base Flood Elevation (BFE) (from Elevation Certificate)

Structure's Elevation (relative to BFE) (from Elevation Certificate)

Date of Elevation Certificate (if available)

Has the Elevation Certificate been reviewed by a qualified professional?

Seller Disclosures & Acknowledgements

6 of 8

Statements and confirmations from the seller regarding flood zone disclosures.

Has the property ever experienced flooding?

If yes, please describe the flooding events (date, severity, damage).

Are you aware of any past flood insurance claims on the property?

If yes, please provide details regarding the claim(s) (date, amount, cause).

Do you have an Elevation Certificate for the property?

If yes, please upload a copy of the Elevation Certificate.

Seller Signature

Date of Signature

Buyer Acknowledgements & Understanding

7 of 8

Confirmation from the buyer that they understand the flood zone disclosures.

I acknowledge receipt of the Flood Zone Disclosure document.

Do you have any questions or concerns regarding the Flood Zone Disclosure information provided?

Have you reviewed the Flood Map (FEMA Map Service Center)?

Describe your understanding of the flood risk associated with this property.

Do you intend to obtain flood insurance?

Buyer Signature

Date

Supporting Documentation

8 of 8

List of documents to be attached as proof of disclosures and determinations.

FEMA Flood Zone Map (Official)

Flood Insurance Rate Map (FIRM) Determination Letter

Elevation Certificate (if available)

Source of Flood Zone Determination

If 'Other' selected above, please specify the source:

Year of Last Flood Zone Map Revision (if known)

Date of Flood Zone Map Review

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