Check this box if you are reporting damage on behalf of someone else, such as a relative or neighbor.
Required
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
ZIP/Postal Code *
Your answer
City *
Your answer
Community Name *
Select what community in the county you live in.
Choose
City of Ashland
City of Catlettsburg
Westwood
Summitt-Ironville
Cannonsburg
East Fork
England Hill
Big Sandy
Norton Branch
Unknown
Home/Cell Phone Number *
Your answer
Type of Damage *
Required
Severity of Damage *
Select your level of damage; Affected is some damage but still habitable. Minor is damaged and uninhabitable but needs minimal repair. Major is damaged and uninhabitable and needs extensive repair. Destroyed is damage resulting in total loss or repairs that are not feasible.
Damage Details
Describe the details of your Damage
Your answer
Utilities Damage
Describe any damage to Utilities, such as Power, Water, Sewer, Gas
Your answer
Community Damages
Use this to report damages not on your property. Such as trees down blocking roads, debris, bridges, culverts, and road damage (no potholes or private driveways)
Your answer
Supplemental Report
Check this box if you have already submitted a damage report, and are reporting additional details or new damage.
Commercial Providers
Note: We cannot accept reports filed on behalf of a resident from a commercial entity, such as a contractor or builder. Please contact your customer's insurance provider.
Disclaimer
Submission of a damage report does not guarantee reimbursement of damages from State, Local, or Federal Officials. Data from this form is gathered and submitted to the State for consideration of a damage declaration. Not all severe weather events will earn a damage declaration.
Acceptance of Disclaimer *
Please read the disclaimer above. If you agree to the disclaimer, please select "I agree".