Damaged or Destroyed Property

First Name *

Last Name *

Damaged Property Address *

City or Township
City of DennisonCity of DundasCity of FaribaultCity of LonsdaleCity of MorristownCity of NerstrandCity of NorthfieldBridgewater TownshipCannon City TownshipErin TownshipForest TownshipMorristown TownshipNorthfield TownshipRichland TownshipWalcott TownshipWarsaw TownshipWebster TownshipWheatland TownshipWheeling TownshipWarsaw TownshipWells Township

Mailing Address

If different from damaged property address.

Phone Number

Email Address *

Date of Damage *

Type of Damage Being Reported *
Flood DamageStorm (wind, hail, etc) DamageOther Damage

Select ANY that apply to your property's damage. *
Foundation damageWater seepage in basementZero to five inches of water in basementSix or more inches of water in basementWater on main level of homeFurnace or water heater damagedElectrical/outlets damagedStorm damage to exteriorSewer back-upOther damage

Briefly Describe Damage to Property

Please leave this field empty.

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