Storm Damage Report
For Tuscaloosa County Residents and Business Owners
Please
prov
ide
the following information about yourself:
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this your primary residence?
*
Yes
No
Residence Type:
Please Select
Manufactured Home
Single Family
Multi-Family
Do you own or rent?
Please Select
Own
Rent
Setting:
Please Select
Urban
Rural
Do you have homeowner's insurance?
*
Yes
No
Don't Know
If this is a business, enter the name:
Date of Severe Weather Event
*
-
Month
-
Day
Year
This report is for:
*
Please Select
Debris Clearance
Residential Damage
Commercial/Industrial Damage
Public Facility Damage
Please describe the damage, and be as detailed as possible (ex. My house is missing shingles and a tree is down in the front yard.)
Add Pictures:
Browse Files
Drag and drop files here
Choose a file
Please take as many pictures as you can to show us the damage. There is no limit to how many pictures you can take. Please help us to see all the damage.
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of
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