Initial Damage Reporting Form

This form is for Initial Damage Reporting only. If there is an emergency, please dial 911.

Please fill out the below form to report storm or disaster-related damage to your home or business.

Submission of this form does not guarantee any type of financial assistance. This form is for information purposes only and will be used when submitting county-wide damage assessments to the State of Florida and FEMA. Information provided on this form may be considered a public record under Chapter 119, Florida Statutes, and may be subject to public disclosure.

Damage Report Type is required
Address is required
Five digit Zipcode is required
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Please enter the following information if this is your property:
Personal Impact
How many people live in your household?
Contact Information
Please provide the following information about yourself: