Individual Damage Assessment Tool
This assessment tool is intended to identify damages to homes/businesses in Victoria County/City of Victoria to help emergency response officials gain an understanding of damages that have occurred due to the May 2021 flash flooding. Please submit ONE survey per impacted address. This information will not be shared to any general public entity. This information is NOT a substitute for reporting damage to your insurance agency and does NOT guarantee assistance.

Informar sobre daños a Manejo de Emergencias es una actividad voluntaria, no sustituye a informar sobre daños a su agencia de seguros y no garantiza la asistencia de socorro en casos de desastre.
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Agreement/Understanding of Individual Damage Assessment Tool *
Is the impacted location a Residence or Business? *
First Name *
Last Name *
Phone Number (ex: xxx-xxx-xxxx) *
Email Address *
Physical/Street Address (*Confirm that this address is correct/verified*) *
City *
State *
Zip Code *
Are you the owner or a renter of this building? *
What type of building is this? *
Are you able to live in the home after the impacts to the building/structure? *
Is the building insured? *
Do you have flood insurance on the residence/building? *
Can you briefly explain what happened to the home/business? (Please be as descriptive as possible) *
Level of damage to the home/business: *
Are you experiencing any public utility outages/issues? *
Do you suspect damage to the public utility lines on the property? *
Are there any other unmet needs you have due to the flash flooding that impacted the Victoria City/County area? *
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