Damage Reports

Please use the following form to submit any damage your property may have received during a severe weather or winter weather event. This information will be used to record damage caused by a weather event in Johnson County. This information may be used in helping to determine if Johnson County or the State may be eligible for assistance from the State or Federal government or other aid sources. Submitting this form does not sign you up for any assistance that may later become available. If any assistance does become available, that information will be sent out at a later date.

    Date of Damage*:

    Property Owners Name*:

    Person Submitting Report (if not Property Owner):

    E-mail*:

    Phone Number:

    Address of Damage*:

    Type of Damage*:
    Single Family HomeMulti-Family HomeBusiness/Commercial PropertyPoultry HouseAgricultural Equipment BarnHay BarnNon-Agricultural Shop/ShedOther (Please explain in description)

    Brief Description of Damage*:

    Is Property Insured*:

    Estimated Cost of Damage (if available):

    Upload Pictures of Damage (up to 5 files):
    Picture 1:
    Picture 2:
    Picture 3:
    Picture 4:
    Picture 5: