Neighborhood Damage Assessment Entry Form

To submit a Damage Report follow these steps:

1. Report the address
Write the address starting with the house number and following with the direction prefix, street name, street type, post direction suffix, city and zip code .

Notice that the direction prefix and direction suffix as well as the street type must be selected from the corresponding drop down list.

House number: Direction: Street Name: Street Type: Dir. Suffix:
City: Zip:

2. Select the Damage/Flood Level
From the Damage Level Pictures 1 though 4 shown below, choose the Damage Level and/or Flood Level Number that more closely resembles the damage in the address you are reporting. Then find the number in the Damage and/or Flood level drop down list.

The Flood Level is indicated by the numbers 5 and 6 shown only in picture 1, but it can be also applied to pictures 2, 3, and 4. Flood level 5 demonstrates street flooded or water level onto the property but outside the home, while flood level 6 demonstrates water level inside the home.

The pictures 1 through 4 can be enlarged by clicking with the mouse on them.

Damage level: Flood level:

3. Submit your Neighborhood Damage Report
Please submit your Neighborhood Damage Report by clicking the SUBMIT button. Thank you for your cooperation!