Delaware County, Indiana

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Delaware County EMA Severe Weather Damage Report form

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Please fill out as completely as possible.

 
THIS IS NOTAN APPLICATION FOR ANY ASSISTANCE PROGRAM
 
Be sure to consult your local permitting official before you start any repairs.

* Denotes a required field
 
Date*
 Date
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Phone*
-- ext
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If you rent, please give property owner information:
 
Owner Phone 
-- ext
 
 
 
 
*
 

Flood Damage Questions

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(You can contact the Delaware County Plan Commission to find out if your house is in a floodplain)

Wind damage Questions

 
Is there structural damage to roof structure? 
 
 
Is there structural damage to walls? 
 

Other Event Damage

Cause? 
 
 
 
 
 
 
Type of damage on structure 
Type of damage to automobile 
 
 
Is this your primary transportation for work or medical needs? 
Type of damage to lot 
 
 

Insurance Info

Is the property insured for this damage? 
*
 
Policy Date: 
 Policy Date:
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