Home Departments Emergency Management Damage Reporting Form for Primary Residences Damage Reporting Form for Primary Residences Name: First, Last:Address:City or Town:State or Province:Zip or Postal Code:Phone:Email:Are you Insured? Yes NoType of Damage? Description of Damage:Cost Estimate of Damages: Do you rent/own the property? Own RentPlease upload files or photos here:Comments:
