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Damage Reports for Primary Homes Form
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Damage Reports for Primary Homes Form
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*
First Name
*
Last Name
*
Address
City
Zip Code
*
Phone
E-mail Address
*
Are you insured?
Yes
No
*
Type of damage
*
Description of damage
*
Do you own or rent the home/property?
Rent
Own
*
Please take photos of your damage and upload them here.
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General Information
Staff Directory
Email
icem@iowacounty.org
Phone Numbers
(608) 930-9540
Fax: (608) 935-0321
Emergencies: Dial 911
Location
109 E. Leffler St.
Dodgeville,
WI
53533
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