bg

Contact Us

Old Town Hall (Directions)
611 Old Post Road
Fairfield, CT 06824

Sullivan Independence Hall
725 Old Post Road
Fairfield, CT 06824

203-256-3000
Find additional contact info here

Public Safety > Emergency Management > Damage Assessment Form

Damage Assessment Form

Submission deadline:  Wednesday, October 17, 2018

This form is to be used by residents or businesses within the Town of Fairfield to report damage from the September 25-26, 2018 severe weather/flooding event.

NOTE: Please determine your FEMA Damage Level BEFORE completing this form.  You will need to select one of the four levels (affected, minor, major or destroyed) below.

For assistance or a paper form please contact the Emergency Management Team at 203-254-4720, 140 Reef Road.


Contact Information

Please enter your name, phone number and an e-mail address so we may contact you if we have questions, information to share, etc.

Property Location

Provide the following Information regarding the location where the property damage occurred.

Extent of Damage

Please answer the following questions regarding the extent and type of damage to the property.

Damage Summary

Please provide a summary describing the damage to your property. You may upload the summary as a document or you can type in a summary directly.

Additional Information




Contact Us

Old Town Hall (Directions)
611 Old Post Road
Fairfield, CT 06824

Sullivan Independence Hall
725 Old Post Road
Fairfield, CT 06824

203-256-3000
Find additional contact info here