Form Center Module

Form Center

The form center is not intended for submitting a public records request.
If you wish to make a public records request click here.
By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
Sign in to Save Progress

Report Damage - Residents

Steps

  1. 1. Occupant Information
  2. 2. Contact Information
  3. 3. Location of Damage
  4. 4. Property & Damage Information

  • Occupant Information

    2. The purpose of this form is to collect information on physical damages to residential structures from emergencies and major disasters. Voluntarily submitting this information is not part of a claims process and does not guarantee reimbursement. Pierce County Department of Emergency Management will use this information to compile a preliminary assessment of all damages incurred throughout the county. You may be contacted at a later date if additional information is needed. You may print this form before pressing submit to keep for your personal records. For more information, contact the Pierce County Damage Assessment Call Center at 1 (866) 798-6363. NOTE: this number is only active after state government instructs Pierce County to collect this information, regardless, this form can be submitted at any time.

    12. Occupant