Maples Survey


* Name:

* Address:

* How long have you lived at or owned property in the maples:

* Please list the dates when your "Maples" Residence Experienced flooding:

* Please describe the extent of damages (property and household contents) from each flooding occurance:

* Do you have flood insurance coverage:

* Please describe any benefits you have received from this coverage

* Please describe any losses of irreplaceable possessions you have suffered as a result of the flood experiences described above:

* Please describe any highwater marks which you can associate with a specific flood

* Have you experienced any life-threatening situations associated with the flooding conditions noted above (please specify)

* Email:

* Phone:


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