Forms

Damage Assessment Forms

Please fill in the Microsoft documents whenever possible to make it easier to read when you submit the forms.  If you use the PDFs, please type or print legibly. Completed documents can be emailed to disaster@franklindes.us

Local Damage Assessment Form   PDF

Damage Report Survey Form   Microsoft Excel   PDF

Initial Damage Report Worksheet - Municipal   Microsoft Excel   PDF

Disaster Damage Assessment Field Worksheet - Individual Property   Microsoft Excel  PDF

Disaster Damage Assessment (Infrastructure Damage - Public Property)     PDF

Small Project Estimating Guide   Microsoft Word   PDF

Completed Project Listing and Claim For Reimbursement   Microsoft Word   PDF

SBA Consolidation Workbook   Microsoft Excel

Economic Injury Survey Form   Microsoft Excel

Summary of Costs Worksheet   Microsoft Word   PDF

Field Observation Report - Click here

NIMS ICS Forms

ICS forms have been updated.  Go to the FEMA website to download.    

EMI / FEMA ICS Job Aids

Pass Tags

Effective May 13, 2013 you must use the revised form for Fire & EMS responders and Municipalities.

Pass Tag Forms for Fire & EMS & Municipalities revised form (pdf)

Pass Tag Forms for Fire & EMS & Municipalities revised form (Word doc)

Pictures can be emailed in .jpg or .tif format to the addresses below. 

Forms can be faxed to 717-267-2813 or emailed to Kelly Knepper at kknepper@franklincountypa.gov and Joanne Sheets at jksheets@franklincountypa.gov

Local EMA Coordinator Forms

Request for Appointment of Municipal Emergency Management Coordinator

Request for Criminal Record Check

Functional Needs Information

Functional Needs Information Form

Versión en español/Formulario para Servicios a Necesidades Especiales