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Revised Flood Waiver Form

The Florida Office of Insurance Regulation (OIR) has approved revisions to Citizens’ flood waiver form, which has been renamed and revised to better express flood insurance responsibilities of the applicant or policyholder. The revised form has been renamed Policyholder Affirmation Regarding Flood Insurance [CIT FW01 (10 19)] and is for new-business and renewal policies effective on and after October 1, 2019. Citizens no longer will accept the old form (Election Not to Buy Separate Flood Insurance) after that date.

Form Revisions

The applicant/policyholder must initial one of the following statements:

  • I elect not to purchase flood coverage.
  • I have purchased flood coverage, but that coverage does not meet the minimum coverage limits established by Citizens’ underwriting guidelines.

The applicant/policyholder must initial each of the following statements:

  • I affirm that I will be responsible for any flood losses not covered by a separate flood insurance policy and that my Citizens policy does not cover flood.
  • I acknowledge that this election shall apply to this policy, all future renewals of this policy and any replacement policy issued to me by Citizens. I understand that execution of this form does NOT relieve me of any obligation I may have to my mortgage company to purchase flood insurance.
  • I affirm that I will have the burden of proving that any damage to my property reported as a water damage claim to Citizens is not caused by the peril of flood.

PolicyCenter Updates

For new-business and renewal policies effective on or after October 1, 2019, PolicyCenter® will be updated:

PolicyCenter Screen Update
Location Information The question Is there a Flood Policy in effect includes a Flood Affirmation Completed option in the drop-down list.
Required Documents Policyholder Affirmation Regarding Flood Insurance is a required document when the Flood Affirmation Completed option is chosen.


  • This revised form will print with the application when applicable.
  • The revised form is available on the Agents website in the General section under PR-M and PR-W.
  • The old form will be removed from the website on October 1, 2019.
  • When an agent submits a policy change for a renewal policy on or after October 1, 2019, the question Is there a Flood Policy in effect in PolicyCenter will include Flood Waiver Completed and Flood Affirmation Completed as drop-down menu answer options. Agents can submit the revised form, but it is not required.


The following resources have been updated to reflect the revised form:

  • The underwriting guidelines and Required Document Guides for each policy form type in the Personal section of the Agents website
  • Home/dwelling owners (wind-only) and renters (multiperil, wind-only) Product Guides located on the Agents website

Legal Disclaimer

Citizens provides agent communications online for historical purposes only, and the communications have not been updated to include any changes that may have been made after publication. Agents can find the latest information by reviewing the applicable underwriting manuals, and by logging in and accessing our FAQs, which are available from the top of any page on our website.