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Storm Damage Survey 2023
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Village of McCook - July 12, 2023 Storm Survey
Last Name
*
Your answer
First Name
*
Your answer
Business Name
Your answer
Address of Property
*
Your answer
Your Email
*
Your answer
Phone Number
*
Your answer
Do you Rent or Own?
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Rent
Own
If you own, do you have a Mortgage?
*
Yes
No
Do you have Insurance
Yes
No
Clear selection
Select which Insurance applies
Rental
Home Owner
Clear selection
If a business, does business have a business owners insurance policy?
Yes
No
Clear selection
Estimated dollar value of business contents
*
Your answer
Estimated dollar value loss of business contents
*
Your answer
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