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Tangipahoa Parish Residential Hurricane Ida Damage Survey
Please complete this short survey if you would like assistance with debris removal and/or clean-up recovery from volunteer groups.
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* Indicates required question
Is the damaged property in Tangipahoa Parish?
*
Yes
No
First Name
*
Your answer
Last Name
*
Your answer
Phone Number you can be reached
*
Your answer
Email Address
Your answer
Physical Street Address of property that has been damaged by Hurricane Ida:
Please give the address of the property that was flooded below.
Street Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Check all that apply for residents at the property
Older than 60
Children in Home
First Responder
Veteran
Anyone in home having special medical needs
Other:
Residence Type
*
Primary - Living in Home
Primary - Displaced from Home
Other type of secondary property (rental, vacation home, etc)
Non-residence, no structures
Other:
Do you Own or Rent this property?
*
Own
Rent
Other:
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