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Adjuster Preliminary Damage Assessment

This form is used by adjusters to list potentially substantial danaged structures in preparation for possible ICC claims.

NOTE: This form is currently under review at the Office of Management and Budget (OMB) and has expired effective April 30, 2017. However, OMB has authorized the continued use of the existing form, until the review process is complete. Upon OMB approval, FEMA will update this record with the new form.

SizePublication Date
Icon for file of type application/pdfFEMA Form 086-0-20
0.37MApril 1, 2014