Initial Damage Assessment for Individual Assistance

Initial Damage Assessment for Individual Assistance

City of Manchester Division of Emergency Management
This form is intended for low to moderate income homeowners, low to moderate income renters, business owners, and private non-profit organizations within the City of Manchester, NH in order to capture initial damage assessment information related to a singular event. The purpose is to collect the necessary data to conduct a State/FEMA Individual Assistance Preliminary Damage Assessment. The data collected should be based on the property damage of homeowoners and renters in the City of Manchester, as well as the economic loss and property damage of businesses and private non-profit organizations.

This form is not a guarantee of federal assistance, but is used to determine whether the City met federal assistance thresholds and help develop any requests for assistance from the City to the State to the Federal government.

If Federal disaster assistance becomes available, the City will communicate the next steps for citizens, businesses and private non-profits.

This form only needs to be completed if your property experienced damages related to a disaster/emergency.

Please complete one form for each property you own or rent within the City.

Event Name*
Damaged Property Address (City of Manchester Addresses ONLY)*

Street Address

Street Address Line 2

CityState

Zip Code
Providing your contact information is optional.

If federal disaster assistance becomes available the City will use a variety of platforms and methods to broadly communicate the next steps.
Property Owner or Renter's Name

First NameLast Name
Property Owner or Renter's Email
example@example.com
Property Owner or Renter's Phone Number
Please enter a valid phone number.