Echo Mountain Fire & Wind Event - Individual or Business Initial Damage Reporting

Please complete one survey per property address.

Select
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What caused the damage?

Please select all that apply

Is your house/property inaccessible?
Primary Building Type
Is the property a rental?
If yes, please select what type.
Primary Insurance Policy Type

Please select all that apply

Quantity of other buildings and structures destroyed or damaged

Please list the quantity of non-primary residence buildings destroyed of damages in the correct box below.

Please list number and type in the box provided

Please list number and type in the box provided

Please select all that apply

Select or enter value
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Displaced individuals, pets, and livestock

Description of Damages

Damage Category - for Primary Residence or Business Structure