NFIP Policy Acknowledgement Form

The purpose of this form is for you to acknowledge that you have received and reviewed the information provided. Following the purchase or renewal of your policy, you should have received the following documents:

From Your Insurance Provider		From FEMA
Flood Insurance Policy Declarations Page Summary of Coverage		NFIP Claims Handbook Your Property's NFIP Claims History This Acknowledgement Form

Review each of these documents carefully to ensure that your personal and policy information is correct. To learn more about or update information on any of these documents, please contact your insurance agent or provider.

Please enter the Acknowledgement Code.

Acknowledgement Code


Policyholder Email			(optional)


Acknowledgement Date

	By submitting this form, I acknowledge the following:
	I acknowledge receipt of the flood insurance documents listed above and I have reviewed them. I understand that contents coverage is not automatically included in a Standard Flood Insurance Policy (SFIP) and I can purchase additional coverage for such contents.

NFIP Policy Acknowledgement Form

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