WA Individual Assistance Form 

CRESA is working with the Washington State Emergency Management Division in collecting initial assessment data to determine the level of individual personal property damage related to the December 2022 Severe Storms (18-28 December). 

This data will be used to determine if Washington State, and by extension Clark County, qualify for FEMA assistance for this event.  At this time we are only collecting information.

If you or someone you know had damages to your primary home, your business, or a loss of business revenue related to the December Severe Storms, please complete this form.  

Please note, completing this form does not ensure you or Clark County will qualify for individual assistance.  At this time, this inquiry is for data collection only as the State of Washington determines if there is enough damage to request Individual Assistance from the federal government.

To be considered, this form MUST be completed by noon on Friday Jan 6th. 

Visit https://mil.wa.gov/recovery for additional recovery resources including steps individuals can take to aid in their initial recovery (e.g., documenting damages, contacting insurance company, etc.). 
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Email *
Last Name 
Primary Phone 
Owner or Renter 
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Primary Cause of Damage  (example: Wind - Tree down)
Homeowner or Renters Insurance (Yes or No)
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Flood Insurance (Yes or No)
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Property in a Flood Zone  (Yes or No)
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Type of Dwelling   (Single Family, or Multi-Family)
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Multi-Family # of Units 
FMV Dwelling 
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Estimated  Real Estate (R/E) Loss to Home ($)
Estimated  Personal Property (PP)  Loss to Home ($)
Water Height above 1st Finished Floor (Example: 2 Feet)
Does the structure have a Basement?
Clear selection
Basement Finished or Unfinished?
Clear selection
Water Height in Basement (Example: 2 Feet)
Do You Have Any Unmet Needs?
Notes/Comments
A copy of your responses will be emailed to the address you provided.
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