Spalding County Long Term Recovery REGISTRATION FOR ASSISTANCEJanuary 12, 2023 Tornado Question Title * Contact Information Name (First, MI, Last) * Street Address * City * 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 Code * Email Address Phone Number * Question Title * Insurance Information (If you do not have insurance, type NA in the Company field) Company Address (Street, City, Zip) Policy Number Question Title * Amount of Funds Received from Insurance Company(Enter numbers and/or numbers and a decimal only. For example, $34,595.95 would be entered as 34595.95; If you do not have insurance or did not receive any funds from insurance, type 0 for the amount.) Question Title * FEMA Information (If you have not filed for assistance with FEMA, type NA in the FEMA Number field) FEMA Number Question Title * Amount of Funds Received from FEMA(Enter numbers and/or numbers and a decimal only. For example, $34,595.95 would be entered as 34595.95; If you did not receive any funds from FEMA, type 0 for the amount.) Question Title * Level of Destruction of Property Next