April 2-3, 2025 Basement Flood Investigation

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Name(Required)

First Last

Your Spouse's, Roommate's or Partner's Name

First Last

Mailing Address(Required)

Street Address City State ZIP Code

Is your mailing address the address that flooded?(Required)

What is the address that suffered the April 2-3, 2025 flood?

Street Address City State ZIP Code

Only complete this if your flooded address is different from the mailing address listed above.

Phone(Required)

Email(Required)

Enter Email Confirm Email

Did sewage/water flood your basement on April 2-3, 2025?(Required)

How many inches of water did you have in your home?(Required)

Was your property damaged as a result of sewage/water flooding your basement on April 2-3, 2025?(Required)

Did your neighbors also suffer flooding?(Required)

Did you file a PA222 written notice of claim with the government within 45 days of discovering the flood damage?(Required)

List the governmental agencies that the contact provided a NOC to for the April 2-3, 2025 flood event:

PA222 Writen Notice of Claim(Required)

Contact provided authoriziation for Dubin Law, PLLC to file the PA222 Notice with the government on their behalf for their August 2, 2024 basement flooding event.

Intake Person

Jakob Kane

Arthur Dore

David Dubin

For More Information

Dubin Law, PLLC