|
<br />I
<br />
<br />I
<br />I.
<br />
<br />~ANFORD RESEARClI INSTITUTE
<br />
<br />f'W9JJ PAMAIl~ S!lRnV
<br />
<br />RES !DENT I A L PROPERTY
<br />
<br />DATE
<br />
<br />/
<br />
<br />I
<br />
<br />,.. m:1EVANT DATA
<br />
<br />INTERVI EWER
<br />
<br />I
<br />
<br />M.yer
<br />
<br />No.
<br />
<br />Date of Flood
<br />
<br />I
<br />
<br />~HY
<br />
<br />Np.
<br />
<br />Address
<br />
<br />~~pop.~ent
<br />
<br />-
<br />
<br />No. of Separate Living Units
<br />in Building
<br />
<br />I
<br />
<br />to!!!~Jrnum j)epj:h :FJoodwaten OUtaide Bldg.
<br />
<br />Inches
<br />
<br />I
<br />
<br />Jg~Jde PJdg. of Floor
<br />
<br />Inches
<br />
<br />"#",Q..in~ "'J~
<br />
<br />JJ()!J.rs
<br />
<br />Minutes.
<br />
<br />=""""""'"
<br />
<br />I
<br />
<br />g9P~~t~{ ff9W much tfm~ d~d you work in an attempt to reduce water damage to the
<br />p~p~rty ~ft~r you he~rd about the rising water?
<br />
<br />I.
<br />
<br />n, VAWE OF J'ROPERTY SURVEYED
<br />
<br />I
<br />
<br />"'amet VJ<J!le 9f P1dg. "r Circla Market Value of Contents Circle
<br />UyiM Unit ill Building One of Bldg. or Living Unit One
<br />"'e~ thg~ $ p,OOO I Less than $ 500 I
<br />$ Ii,POO 7,499 H $ 500 999 II
<br /> 7,pOO !;l,S9S HI 1,000 1.499 III
<br /> 19,000 J:I,49S IV 1,500 1,999 IV
<br /> I;I,liOll H,!;l99 V 2,000 2,499 V
<br /> IP,OOO 17,499 VI 2,500 2,999 VI
<br /> i7,liOO W.999 VH 3,000 3,499 VII
<br /> ;19,900 :12,499 VIlI 3,500 3,999 VIII
<br /> ;I;!,pOO 24,S99 IX 4,000 4,499 IX
<br />lip ,000 J!7,499 X 4,500 4,999 X
<br /> 1I1,pOO 29,999 XI 5,000 5,499 XI
<br /> ~O,OOO ~2,499 XII 5,500 5,999 XII
<br />~;l,pOO ~4,999 XIlI 6,000 6,499 XIIl
<br /> 3p,009 37,499 XIV 6,500 6,999 XIV
<br /> 31,pOO 39,999 XV 7,000 7,499 XV
<br />40,000 Over XVI 7,500 Over XVI
<br />If OYer $40,000.00, If over $7,500.00.
<br />f:aHl11atell Value: $ Estimated Value: $
<br />(eatll11ate to nearest $5,000) (estimate to nearest $2,000)
<br /> 15
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I.
<br />I
<br />
<br />I
<br />
<br />r.
<br />..... .'
<br />};" .
<br />
|