Pre Disaster Assessment survey 1. Default Section Question Title * 1. Please provide the following contact information: Name: * Address: * City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. Is this property occupied by: Owner Renter Question Title * 3. Is this propery accessible for inspection at a later date? Yes No Question Title * 4. Are you still able to live in the home? Yes No Question Title * 5. Is this property a: Single Family home Multi-Family home Mobile home Question Title * 6. What type of insurance do you have for this property? Structure and Contents Contents Flood None Question Title * 7. What is the deductible on the policy? Question Title * 8. Have you contacted your insurance company and also documented the damage for your own records (ie photos, videotape)? Yes No Unsure Question Title * 9. please describe the damage to your property Done