Damage Assessment Information

If your home or business has experienced damage such as water getting inside or some type of other structural damage, please complete the following information."

This information is being collected to assist in information in order to begin damage assessments and complete reporting after the recent Hood County Disaster Declaration and the State of Texas Disaster Declaration.

Your assistance is greatly appreciated.

Contact Information

Please provide contact information in case we have any questions with this form.

Name:*

Phone:*

Email:

Site Damage Information

Is this a Business or Residential site?*

Residential

Business

Address of site damaged:*

City:*

State:*

Zip code:*

Date damage occured:*

Approximate time damage occurred (if known):

Description of damage:*

If you have digital pictures, you can attach them here.

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Disclaimer

• This form is for information gathering purposes only. Submitting this form does not provide guarantee of funding disbursements from Hood County, FEMA, or other entities.