Federal Emergency Management Agency

Adjuster Preliminary Damage Assessment

Main Content
This form is used by adjusters to list potentially substantial danaged structures in preparation for possible ICC claims.
SizePublication Date
Formerly FF81-109
October 1, 2010
Icon for file of type text/plainFormerly FF81-109
4.21KOctober 1, 2010
Icon for file of type application/pdfFormerly FF81-109
229.35KOctober 1, 2010