1- Enter your Business Address
 
 Street Number Pre Dir. Street Name   Street Type   Post Dir.   Apt/Unit  
                        
 City State Zip Code        
                 

 
2- Select the Damage Level and Flood Level (Click on Image)
 
  Damage Level
Low Damge (Double click to view larger image) Moderate Damge (Double click to view larger image) High Damge (Double click to view larger image) Extensive Damge (Double click to view larger image)
  Flood Level  
Not Flooded (Double click to view larger image) Flooded at Street Level (Double click to view larger image) Flooded Inside (Double click to view larger image)  


 
3- Business Information
 
Business Name:        Is Business Operational?  

 
4- Upload a Photo (Optional)