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August 23, 2023 Flood Phone Intake

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 August 23, 2023 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 August 23, 2023?(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 August 23, 2023?(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 August 23, 2023 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 April 4-5, 2023 basement flooding event.

Intake Person

Jakob Kane

Ciel Neff-Aldrich

David Dubin

August 23, 2023 Flood Phone Intake

For More Information

Dubin Law, PLLC