Lackawanna Flood-Plain Insurance Survey

July 30, 2012

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* Indicates Required Field

1.
Do you own your home/property? *
(Select one)

Yes
No
2.
Do you own rental/income property? *
(Select one)

Yes
No
3.
Which income category most closely approximates your income? *
(Select one)

Under $15,000
$15,000-$25,000
$25,000-$40,000
$40,000-$60,000
Over $60,000
4.
If you do own your home/property, do you currently have a first or second mortgage out on your home? *
(Select one)

Yes
No
5.
Do you pay for flood-insurance on this property? *
(Select one)

Yes
No
6.
Was obtaining flood-insurance for your home/property a requirement for obtaining this mortgage? *
(Select one)

Yes
No
Unsure
Not Applicable
7.
Who is your flood-insurance provider? (Provide provider’s name and address) *
8.
8.) How much do you pay annually for flood-insurance on your home/property? *
9.
Has the amount you pay annually for flood-insurance on your property increased over the past 5 years? *
(Select one)

Yes
No
10.
If the amount you pay annually has increased, by approximately how much has it increased? *
(Select one)

It has not increased
Less than $100
$100-$200
$200-$300
Over $300
11.
11.) Have you ever filed a claim for flood related damages with your flood-insurance carrier? *
(Select one)

Yes
No
12.
If you have filed a flood-insurance claim for damages, were you reimbursed by your flood-insurance carrier? *
(Select one)

Yes
No
13.
Have you ever privately had your home/property surveyed for elevation? *
(Select one)

Yes
No
14.
If you have privately had your home/property surveyed for elevation, do you recall what this measurement was? *
15.
Do you currently pay for additional coverage (rider to homeowner’s insurance) to protect you home/property from basement flooding? *
(Select one)

Yes
No
16.
If you pay for additional coverage to protect your home/property from basement flooding, how much do you pay annually? *
17.
Do you have any additional information that you think may be useful in this survey or the resolving of this issue? *
This survey is strictly for information gathering purposes only, answering these questions is optional. All answers to these questions are optional and not mandatory. Participation in any or all questions is at the discretion of the respondent.