Interest Questionnaire

Fill out this interest questionnaire to be reviewed for eligibility into a CDBG-DR Housing Program by a Fahe Disaster Resilience Team Member. Once reviewed, a Fahe DR Team Member will reach out to you for additional information and next steps.

*Contact Name:
Email:
*Phone:
*Current Street Address:
*Current City:
*Current State:
*Current Zip:

Flooded Property Owner First Name:
Flooded Property Owner Last Name:
Flooded Property Street Address:
Flooded Property City:
Flooded Property State:
Flooded Property Zip:
Tax County:

Disaster year:
Which disaster impact affected you?:
Current living situation:
Do any following situations apply?
Do you own or rent flooded property?
Have you received FEMA assistance?
Have you received any additional disaster assistance?
Have you participated in a buyout program?
Documentation to prove ownership?
Preference regarding location of home?
Which site are you interested in applying for?
Estimated household income:
Home size:
Referral source:

Email us your documentation here

*Required field

By submitting this form, you give permission to share information requested in this survey with Fahe, its Members, & its Federal, State, & Local partners. The survivor understands the purpose of this information is to create a database for Disaster Recovery services and screen for eligible applicants for upcoming CDBG-DR Housing Programs.