Basic Damage Report Type Of Event (Fire Storm Etc)

basic damage report type of event (fire, storm, etc): _________________________________ report date: ____________________________ prop

Basic Damage Report
Type of Event (Fire, Storm, etc): _________________________________
Report Date: ____________________________
Property Name: ____________________________________________
EMAIL:________________________________
Address: _________________________________City :
__________________________ County: _____________________________
----------------------------------------------------------------
(with Zip Code)
Contact person: _______________________________________ Contract
Phone: _______________________________
Was there any damage due to the event? If yes, please explain:
Were any residents displaced as a result? If so, how many and where
were they relocated to?
Are there any vacant units that may be used for housing residents
displaced by the event? If so, please indicate as follows:
(Note: availability varies constantly – places contact property for
information)
Unit size:
0 BR
1 BR
2 BR
3 BR
4+BR
Subsidized
Un subsidized
Subsidized
Un subsidized
Subsidized
Un subsidized
Subsidized
Un subsidized
Subsidized
Un subsidized
# of units available:
# of Applicants Waiting List
Date of first availability
Deposit amount:
Rent amount:
Comments:
Resource Description: (Please check all that apply)
===================================================
Appliances provided: ___Stove ___Refrigerator ___Dishwasher
___Microwave
Utilities provided: ___All ___None ___Cable TV ___Electric ___Propane
___Gas ___Sewer
___Trash ___Water ___Heating Oil
Lease required: ___None ___3 mos. ___ 6 mos. ___9 mos. ___ 12 mos.
___Month to Month Other: ____________
Type of dwelling: ___Apartment ___Mobile Hm. ___ Duplex ___Efficiency
___House
___Condo ___ Room ___Studio ___Townhouse ___Trailer
Please check all that apply to the property: ___Children ___Furnished
___Pets Allowed
___ Handicap Accessible ____Section 8
Completed by: _________________________________