Umatilla County Damage Assessment

Reporting Individual (Owner or Renter)

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First Name

Last Name

Property Street Address

City

Zip Code

Contact Phone Number

Contact Email

Building Type

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Primary Insurance Policy Type

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Do you have extra insurance coverage?

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Estimated Damage Amount

Is your house/property inaccessible?

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If yes, what caused the inaccessibility?

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Damage Category

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Does the property have a basement?

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What caused the damage?

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Description of damages

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