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2. NOTE: You do not need to create an account to complete this form. Use this form to report damaged or destroyed property to the Blue Earth County Assessor's Office. Our Taxpayer Services department staff will contact you soon to assist you.
4. First Name*
5. Last Name*
7. Damaged Property Address*
8. City or Township*
   -- Select One --AmboyEagle LakeGood ThunderLake CrystalMadison LakeMankato CITYMapleton CITYMinnesota LakeNorth MankatoPembertonSkylineSt. ClairVernon CenterBeauford TownshipButternut Valley TownshipCambria TownshipCeresco TownshipDanville TownshipDecoria TownshipGarden City TownshipJamestown TownshipJudson TownshipLeRay TownshipLime TownshipLincoln TownshipLyra TownshipMankato TOWNSHIPMapleton TOWNSHIPMcPherson TownshipMedo TownshipPleasant Mound TownshipRapidan TownshipShelby TownshipSouthbend TownshipSterling TownshipVernon Center TownshipOther
10. Owner's Mailing Address
11. Relationship to Property*

    1. Owner
    2. Renter
    3. Other
13. Daytime Phone Number*
14. Evening Phone Number*
16. E-mail Address
18. Parcel ID (if known)
19. Does the Owner of the Property live at the Damaged Property Address?*

    1. Yes
    2. No
20. Date of Damage*
    Date of Damage
22. What kind of damage are you reporting?*

    1. Flood Damage
    2. Storm (tornado, wind, etc.) Damage

    1. Fire Damage
    2. Other Damage
24. Please check ANY that apply to your property's damage.*

    1. Foundation cracking
    2. Foundation bowing
    3. House twisted on foundation
    4. Water seepage in basement
    5. Furnace damaged
    6. Water heater damaged
    7. Electrical/outlets damaged
    8. Water on main level of home

    1. Public agricultural drainage system damage
    2. Storm damage to siding or windows
    3. Storm damage to shingles
    4. Storm damage to building structure(s) (the roof, walls, etc.)
    5. Storm damage to outbuildings (sheds, barns, etc.)
    6. Fire damage to building(s)
    7. Other vandalism damage
    8. Other damage
26. Was there Water in the Basement*

    1. No water in basement
    2. 0-3 inches
    3. 3-6 inches
    4. 6-18 inches
    5. 18-30 inches
    6. More than 30 inches
28. Briefly Describe Damage to Property*
30. Do you have Homeowners Insurance?*

    1. Yes
    2. No
31. Do you have flood insurance?

    1. Yes
    2. No
33. Provide any comments regarding insurance coverage. (Optional)
Leave This Blank:


35. Submit

* indicates a required field