Form FEMA Form 009-01T FEMA Form 009-01T Tele-Registration Application for Disaster Assistance

New Registration

 

Registrations Instructions

 

Privacy Act Statement and Declaration of Eligibility

 

Personal Identification

 

Contact Phone Numbers

 

Damaged Dwelling Address

 

County/Parish/Municipio

 

Disaster Selection

 

Damage Type

 

Damage Type  “Other”

 

Disaster Related Losses

 

Damaged Dwelling

 

Damage Dwelling (Drop Down for Owner to first question) Where are you currently living or staying?

 

Damaged Dwelling (Drop Down to second question) What type of home are you registering?

 

Damaged Dwelling (Drop down to third question) Is this your primary residence…….?

 

 

Home Insurance

 

Disaster Related Expenses

 

Other Insurance

 

Disaster Related Vehicle Damage

 

Vehicles

 

Update Vehicle

 

Emergency Needs

 

Special Needs General Categories

 

Special Needs Specific Categories

 

Occupants

 

Update Occupant

 

Business Damage

 

Financial Information (when selecting self employed) from previous screen

 

Financial Information when selecting No to self employed

 

Electronic Funds Transfer

 

Correspondence Preferences

 

Correspondence Preferences when selecting E-mail

 

SMS Correspondence Summary

 

SMS Correspondence Summary when selecting Yes

 

Program Referrals

 

Agency Referrals

 

Close Interview

 

 

Conclusion

 

 

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