Flood Damage Assessment (December)
If you attend New Covenant Church and your home flooded in August 2016, please take the time to answer the following questions. Your answers will remain completely confidential and will be used to determine the level of financial assistance we may be able to provide you as you rebuild. Only complete this information IF YOUR PRIMARY RESIDENCE FLOODED. If you rented your residence and did not own it and suffered loss, please complete the form as well. By submitting this information, you are indicating that it is true and accurate.
Last name
Your answer
First name
Your answer
How much water did you receive?
Did you have flood insurance?
IF you have flood insurance, please indicate your coverage amount on your home's STRUCTURE (round to nearest thousand)
Your answer
IF you have flood insurance, please indicate your coverage amount on your home's CONTENTS (round to nearest thousand)
Your answer
Did you lose any vehicles in the flood? If so, how many?
How many children lived with you in your home that flooded?
Are there any additional relatives living with you since the flood?
How many appliances will you have to replace (e.g. refrigerator, washer, dryer, freezer, etc.)?
Did you lose any stored belongings at a rental/storage facility due to flooding?
If you received funds from FEMA, please indicate how much (round to nearest thousand)?
Your answer
If you received or will receive a settlement from the National Flood Insurance Program, please indicate the total amount you anticipate receiving.
If you have flood insurance, this is where you will indicate what your adjuster indicated you will receive for your losses.
Your answer
What are your estimated total losses in the flood (damage to home + loss of vehicles + loss of contents)?
Your answer
What is your greatest need at the moment as you recover from the flood? How can we best help you or what help can we try to arrange for you?
Your answer
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