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2022 Wildfires Damage Assessment Form

Name(Required)
Address(Required)
Are you 18 years old or older?(Required)
Is the impacted location a Residence or Business?(Required)
Are you the owner or renter for this location?(Required)
Are you the Point of Contact for this Property?(Required)
Is the listed address associated to a 2022 wildfire identified below?(Required)
At the address listed above, was there any property destroyed due to a 2022 wildfire?(Required)
If you said yes to property being destroyed due to a 2022 wildfire, please identify the type of property that was destroyed.(Required)
If a building was identified above, what type of building is this?(Required)
If you selected Primary or Secondary home in the previous question, do you have homeowner's or renter's insurance?(Required)
Are you able to live in the home after the disaster impacts?(Required)
If property is a business, what type of building is this?(Required)
If you selected Business as being destroyed due to a 2022 wildfire, do you have business owner's policy?(Required)
Do you need cleanup assistance?(Required)