Not always. Many insurers accept unsigned or electronically signed affidavits, but lenders and courts often require notarization. Verify the recipient's requirements before signing to avoid re-execution.

Can I sign electronically?

Yes. Electronic signatures generally meet ESIGN (15 U.S.C. ch. 96) and UETA standards in most states, but some uses still require notarization or witness signatures.

What supporting documents help?

Provide dated photos, repair estimates, receipts, police or municipal reports, and contractor invoices. Detailed documentation reduces additional information requests and speeds claim resolution.

How long keep records?

Retain the affidavit and supporting records through claim settlement plus at least the federal minimums (e.g., IRS three-year rule) and longer if litigation is possible.

What if facts change?

Prepare a corrected affidavit or amendment with a clear statement of what changed, dated and signed. Notify the insurer and any other recipients promptly to maintain accuracy.

Who can notarize remotely?

States vary. Many permit Remote Online Notarization (RON); check your state notary commission. If RON is allowed, follow the provider's identity-proofing and recording requirements.

Electronic Signature
Templates
Insurance
Insurance Flood Affidavit

Insurance Flood Affidavit

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

INSURANCE FLOOD AFFIDAVIT

Insurer and Policy Information

Insurer Name: Policy Number:

Agent / Broker:

Policy Type:

Policy Period: From to Coverage Limit: $ Deductible: $

Applicant / Insured Information

Insured Full Legal Name: Mailing Address:

Phone Number:

Email Address:

Date of Birth:

Flood Event Details

Date of Loss: Time of Loss:

Location of Loss (property address):

Primary Observed Source of Flooding (check all that apply):

River or stream overflow
Storm surge/coastal flooding
Sewer or drainage backup
Heavy rain / surface water
Dam or levee failure
Other (describe):

Was the property vacant or unoccupied at time of loss?

Yes No

Description of Damage

Provide a detailed description of affected property, structure, and contents: Estimated Total Damage Amount (repair/replacement): Are there immediate safety hazards or structural instability? Yes No

Documentation Checklist

Please indicate which documents are attached or will be provided to support this affidavit:

Photographs of damage
Contractor repair estimates
Receipts for damaged items
Floor plans / property diagrams
Proof of ownership (titles, bills of sale)
Official municipal / emergency report
Other (describe):

Exclusions and Acknowledgements

The undersigned acknowledges that coverage for flood damages may be subject to policy terms, conditions, and exclusions. Common exclusions include but are not limited to: earth movement or subsidence not caused by inundation, wear and tear, mold and mildew arising from excluded causes, pre-existing damage, intentional acts, and losses not resulting from a direct influx of surface water or overflow of natural watercourses. Submission of this affidavit does not constitute an admission of coverage or waiver of any policy provision.

I acknowledge that I have read and understand the exclusions above: Applicant acknowledges exclusions

Beneficiary for Policy Proceeds (if applicable)

Complete beneficiary designation only if claim proceeds should be paid to a person or entity other than the insured.

Primary Beneficiary Name:

Relationship to Insured:

Share Percentage:

Contingent Beneficiary Name (optional):

Affidavit, Certification and Authorization

I, the undersigned, being first duly sworn, declare under penalty of perjury that the information provided in this affidavit is true, accurate, and complete to the best of my knowledge. I affirm that I am the named insured or an authorized representative of the named insured with authority to execute this affidavit on behalf of the insured. I understand that any material misstatement, omission, or fraudulent statement made in connection with this affidavit or any claim may result in denial of coverage and may subject me to civil or criminal penalties under applicable law.

I authorize the insurer, its representatives, and any appointed adjusters or contractors to inspect the damaged property and to obtain and review records, receipts, or other documentation necessary to adjust this claim. I agree to cooperate with reasonable requests for information and documentation to support the claim and to preserve damaged property until inspected, unless otherwise instructed by the insurer for safety reasons.

Additional remarks or special instructions:

Applicant Printed Name:

Signature:

Date:

What the Insurance Flood Affidavit Is and when it matters

An Insurance Flood Affidavit is a sworn written statement used to report flood-related damage, document the circumstances of loss, and support an insurance claim. The affidavit records facts such as date and time of the flood event, property address, description of damage, actions taken to mitigate loss, and any third-party reports. Insurers, mortgage servicers, and public assistance programs use the affidavit to verify claims, determine coverage, and calculate payments. Accuracy and supporting documentation are essential because the affidavit becomes part of the official claim record and may be relied upon for settlement, subrogation, or audit.

Why an Insurance Flood Affidavit matters for claims and compliance

A clear affidavit speeds claim handling and documents your sworn account of the loss for insurers, lenders, and public programs. Electronically signed affidavits meet U.S. legal standards under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, though notarization or witnesses may still be required for certain uses.

Who commonly completes and signs a flood affidavit

Typical filers and signers include property owners, tenants, insurance claimants, adjusters, and lending or mortgage representatives.

Property owners reporting damage to their homeowner or flood insurer for indemnity claims.
Tenants documenting personal-property loss and leasehold conditions for landlord or insurer review.
Insurance adjusters and public adjusters preparing a sworn statement to support an estimate.

The exact signer set depends on the insurer, mortgage servicer, and whether a notarized or witnessed affidavit is required.

Step-by-step: completing an Insurance Flood Affidavit

Follow these steps to prepare a complete, insurer-ready affidavit.

01

Gather evidence: Collect photos, receipts, and repair estimates before drafting.
02

Fill fields: Enter names, address, date, and damage descriptions carefully.
03

Attach docs: Upload supporting photos, invoices, and repair quotes.
04

Sign and notarize: Electronically sign or notarize according to insurer or lender rules.

Essential parts of a professional Insurance Flood Affidavit

A complete affidavit contains structured sections that insurers and lenders expect; assemble each element to ensure the statement is actionable and admissible.

Declarant details

Name, contact information, relationship to the property, and identification reference to establish attribution and authority to file the affidavit.

Property description

Full property address, parcel or mortgage account number, and occupancy status to link the affidavit to the insured risk.

Loss facts

Clear chronology of events, flood origin, water levels if known, and the exact date/time of the incident to support cause and timing of loss.

Damage inventory

Itemized list of damaged structures and personal property with approximate quantities and values to support estimates and proof of loss forms.

Mitigation actions

Description of emergency repairs, contractors engaged, and receipts to show reasonable steps taken to prevent additional damage.

Attestation and notarization

Sworn signature, date, and notary block where required so the affidavit is legally binding and acceptable to third parties.

Critical data fields to include

Declarant name: Full legal name

Property address: Street, city, state, ZIP

Date of loss: MM/DD/YYYY

Damage summary: Brief itemization

Supporting docs: Photos and receipts

Signature: Signed and dated

Where to file or send the completed affidavit

Routing depends on the purpose: insurer claim file, mortgage servicer, NFIP (if applicable), or local emergency assistance programs.

Primary insurer: Submit affidavit to the insurer listed on the policy or claim portal.
Mortgage servicer: Send copy to the loan servicer when mortgage interest or escrow is involved.
Public programs: Provide affidavit to FEMA or local assistance if requested for aid eligibility.
Legal counsel: Share a notarized copy with an attorney when legal review or litigation is possible.

Digital signing and distribution considerations

Use secure e-signature tools and a tamper-evident PDF for reliable attribution, audit trail, and reproduction.

File formats: PDF or DOCX preferred
Authentication: Email, SMS, or stronger ID
Integrations: Connect to insurer portals

Choose a solution that provides an auditable certificate of completion, supports conditional fields for notarization, and integrates with cloud storage or claims management systems.

Timing: common deadlines and expectations

Act promptly after a flood event; insurers and programs set differing deadlines for notice, documentation, and claim submission.

Initial notice:

Notify insurer as soon as possible; many policies require prompt notice.

Proof of loss:

Provide a detailed proof of loss per insurer timelines, often within 30–90 days.

Mortgage reporting:

Notify mortgage servicer promptly to protect escrow and force-place insurance rights.

Public assistance:

Submit documents to FEMA or local programs per their application windows.

Record retention:

Keep originals until claim closure and for the retention period required by law.

Common mistakes to avoid when preparing an affidavit

Incomplete dates or ambiguous timing that make it hard to prove when the loss occurred.
Omitting supporting documentation such as photos, receipts, or contractor estimates.
Using informal or shorthand addresses instead of full legal property descriptions.
Failing to notarize or obtain required witnesses when the insurer or lender requests them.

Risks and consequences of errors or false statements

Claim denial: Possible

Policy cancellation: Possible

Civil liability: For misstatements

Perjury risk: If sworn falsely

Recovery action: Insurer may seek reimbursement

Mortgage default: Escrow or force-placed insurance issues

Typical eSignature vendor comparison for signing and notarizing affidavits

Comparison of common vendor features and starting prices for eSignature platforms used to sign and distribute Insurance Flood Affidavits; signNow appears first as the initial column.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	Limited
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies	Varies	Varies

Frequently asked questions about Insurance Flood Affidavits

Answers to common questions about completion, notarization, submission, and recordkeeping for flood affidavits.

Need help? Contact support

Do I need a notary?
Not always. Many insurers accept unsigned or electronically signed affidavits, but lenders and courts often require notarization. Verify the recipient's requirements before signing to avoid re-execution.
Can I sign electronically?
Yes. Electronic signatures generally meet ESIGN (15 U.S.C. ch. 96) and UETA standards in most states, but some uses still require notarization or witness signatures.
What supporting documents help?
Provide dated photos, repair estimates, receipts, police or municipal reports, and contractor invoices. Detailed documentation reduces additional information requests and speeds claim resolution.
How long keep records?
Retain the affidavit and supporting records through claim settlement plus at least the federal minimums (e.g., IRS three-year rule) and longer if litigation is possible.
What if facts change?
Prepare a corrected affidavit or amendment with a clear statement of what changed, dated and signed. Notify the insurer and any other recipients promptly to maintain accuracy.
Who can notarize remotely?
States vary. Many permit Remote Online Notarization (RON); check your state notary commission. If RON is allowed, follow the provider's identity-proofing and recording requirements.

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