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Damage Reports for Primary Homes Form
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Damage Reports for Primary Homes Form
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*
First Name
*
Last Name
*
Address
City
Zip Code
*
Phone
E-mail Address
*
Are you insured?
Yes
No
*
Type of damage
*
Description of damage
*
Do you own or rent the home/property?
Rent
Own
Please be aware photos of damage may be requested once form is submitted.
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Deputy Director
Amanda Gardner, C.E.M.
Work: 608-930-9541
Cell: 608-553-1481
amanda.gardner@iowacounty.org
General Information
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Fax: (608) 471-1067
Emergencies: Dial 911
Location
109 E. Leffler St.
Dodgeville,
WI
53533
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