Skip to content

(708) 891-8106

Email us

Facebook-f Twitter Youtube

Home
- - - Fire and Police
    - City Offices
  - - City Department Directory
Government
Residents
Community
Businesses
News
Events
Contact

Home

/

Calumet City Residential Flood Form

Disclaimer:

Thank you for applying for possible Disaster assistance from the City of Calumet City for the flood that occurred on Sunday, September 17, 2023. Calumet City is collecting data to submit to the State and Federal government for possible assistance. Mayor Thaddeus Jones is working with the City Council to authorize funds for limited restoration use to residents. The first step in this process is to apply for assistance through your insurance company. Please be aware of scam agents who are not authorized by the Mayor, Council or Police Department to come to your house. Please report any scam agents to the Police Department. All City employees will have a City ID to enter your home.

Full Name*

Email*

Date of Flood*

Phone*

Address*

Address 2

Condo/Apartment#

City*

State*

Zip*

Residential Questionnaire*

1.) Do you Rent or Own? (Rent/Own)*RentOwn

2.) If you own, do you have a Mortgage? (Y/N)*YesNo

3.) Do you have Insurance? (Yes/No)*YesNo

4.) Select Which Insurance applies *RentalHome Owner

Business Questionnaire*

Do you own a business?*YesNo

If “Yes” please complete the business information below. If "No" please enter N/A.

Business Name*

Contact Name*

Business Phone*

Business Email*

Business Address*

Business/Suite #

City

State

Zip

1.) Does the Business Rent or Own property? (Rent/Own)*RentOwnN/A

2.) Does the Business have a Business Owner’s Insurance Policy? (Y/N)*YesNoN/A

3.) Does the Business have a Mortgage? (Y/N)*YesNoN/A

4.) Estimated dollar value of Business Contents:*

5.) Estimated dollar value loss of Business Contents:*

Flood Concern*Sewer BackupSeepageOverhead and FloodingSump PumpOther

If "Other" is checked, please choose the appropriate topic that covers your flooding concern

Sewer System*GravityOverheadOther

If "Other" is checked, please identify your sewer system

Is this a living area?*YesNo

Did your flooding occur in a living area?

Flood Duration*0-3 hours4-6 hours6-10 hours10-15 hours15+ hours

Amount of Flood (in inches)*0-3 inches4-6 inches6-10 inches10-15 inches15+ inches

I would like to receive text messages from the city. By checking this box, you agree to receive alerts, community updates, and informational items via text message from the City of Calumet City. Message frequency will vary, and message and data rates may apply. Subscribers will have the opportunity to opt-out from receiving text messages at any time by replying STOP to unsubscribe. Review our Text Message Privacy Statement

*Upon submitting this form, a confirmation email will be sent to your inbox. By checking this box, you are agreeing that your email address is correct and all information provided is correct.