FEMA Flood Elevation Certificate
Section A – Property Information
Building Owner's Name
Street Address
City
State
ZIP Code
Building Use
Lot/Block/Parcel No.
Other Description
Section B – Flood Insurance Rate Map (FIRM) Information
NFIP Community Name & Number
County
FIRM Panel Number
Suffix
FIRM Index Date
FIRM Zone
Base Flood Elevation (BFE)
Datum
Section C – Building Elevation Information
Item
Elevation (feet)
Datum
Top of Bottom Floor (including basement, crawlspace, or enclosure floor)
Top of Next Higher Floor
Attached Garage (top of slab)
Lowest Elevation of Machinery/Equipment
Section D – Surveyor, Engineer, or Architect Certification
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
Name
Title
License Number
Company Name
Signature
Date
Comments