Storm Damage Reporting

Stamford Police Department Stamford Fire Departments Emergency Communications Alarm Registration Ordinance 911 Emergency Health and Social Services Animal Care & Control Shelter	Storm Damage Report The City of Stamford is collecting data on damage caused by the recent storm and flooding. If you experienced any damage, flooding, or property loss from the storm please help us by completing this simple form. The information collected will help the State determine the extent of damage caused by the storm and will be used by FEMA to determine what level of federal aid will be granted to the State and its residents. This form is for Stamford residents and businesses ONLY!
	First Name:
	Last Name:
	Address:
	City, State, Zip:	Stamford, CT
	Home or Business:	-- Select One -- Home Business
	Business Name:
	Type of Damage:
	Estimated Dollar Loss:	$
	Flood Insurance:	-- Select One -- No Yes
	Email:
	Home Phone:
	Business Phone: