Fire Damage Assessment Report Form

Fire Damage Assessment Report Form
Complete this report to document and evaluate fire-related damage for property assessment purposes.
Date of Assessment
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Assessor Name
First NameLast Name
Property Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Property
Other
Suspected Cause of Fire
Rooms/Areas Affected
Other
Damage Severity by Area
Rows No Damage Minor Moderate Severe
Structure
Contents
Electrical
Plumbing
Overall Fire Damage Rating
Immediate Safety Hazards Present?
Summary of Findings and Recommendations
Should be Empty:

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