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NCEM Project Grant Application
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* Indicates required question
Email
*
Your email
Owner Information
Name of Structure Owner(s)
Your answer
Name of Land Owner(s) (if different)
Your answer
Street Address of Damaged Property
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Mailing Address
Your answer
Mailing City
Your answer
Mailing State
Your answer
Mailing Zip Code
Your answer
Phone Number
Your answer
Citizenship Status
United States Citizen
Non-Citizen National
Qualified Alien of United States
None of Above
Clear selection
Have you applied for disaster assistance in the past 10 years?
Yes (list below)
No
Clear selection
If yes, please provide your FEMA registration number and what disaster it was associated with:
Your answer
Did you have flood insurance on the structure at the time of loss?
Yes
No
Clear selection
Was your home determined to be substantially damaged by local officials?
Yes
No
Clear selection
How many claims have you filed for flood insurance in the past 10 years?
Your answer
If you received claim money, how much did you receive?
Your answer
Have you made a claim with your flood insurance agent for increased cost of compliance coverage?
Yes
No
Clear selection
Flood insurance agent/company:
Your answer
Flood insurance policy number:
Your answer
Are you requesting:
Acquisition "buy-out"
Elevation "house raising"
Mitigation Reconstruction "demo/rebuild"
Clear selection
Have you participated or applied for assistance in a previous acquisition, elevation, or mitigation reconstruction program? If yes, when?
Your answer
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