Form

Disaster Recovery Loan Reporting

Quarterly Reporting as Required Under Exhibit G of Loan Agreement
Program*
Borrower Responding*
Contact Name*

First NameLast Name
Email*
example@example.com
Borrower is electing to provide 50% of FEMA reimbursements (see memo from May 1, 2024 for explanation):*

On an on-going basisAfter 50% of reimbursements are received
Reporting Period Ending (due 30 days after end of quarter)*

MonthDayYear
Date
Disaster Number*
Example: 4720

FEMA Reporting - Total Damage Inventory & Reimbursements from FEMA*

	Damage Inventory	Reimbursements Received	Reimbursements Received as % of DI
FEMA Categories A&B
FEMA Categories C-G
Total

Disaster Recovery Loan Reporting