Manitoba
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Emergency Measures Organization

Application for Disaster Financial Assistance

Any personal information you provide through the Emergency Measures Organization Disaster Financial Assistance application is collected in compliance with The Freedom of Information and Protection of Privacy Act. The personal information you provide will be used only for the purpose(s) for which it is collected, and not in any other way without your consent.

This information is being collected as part of the applicant's request for Disaster Financial Assistance. Emergency Measures Organization has responsibility for administering the Disaster Financial Assistance program as per The Emergency Measures Act.

Complete a DFA Application:

  • Complete and submit the on-line application form below, or
  • Download English Application (PDF, 64 KB). Fax or mail the completed form to EMO.

If you have any questions about Disaster Financial Assistance or your application, please contact:

Manitoba Emergency Measures Organization
1525-405 Broadway, Winnipeg MB R3C 3L6
Phone: (204) 945-3050 or toll free 1-888-267-8298
Fax: (204) 945-4929
Email: dfa@gov.mb.ca

Items marked with asterisk (*) are required to submit the application.

Applicant Information

First Name, Business or
Organization Name*:
Middle Name Initial:
Last Name:
Mailing Address*:
City/Town/Village*:
Province*:
Postal Code:
Contact person name:
(if different than above)
Contact Phone Number 1*:
Contact Phone Number 2:
Contact Phone Number 3:
Email Address:

Disaster and Damaged Property Information

Date of damage*:
(yyyy/mm/dd)
Type of Event:
(e.g. flood, tornado...)
Local Authority of
Damaged Property*:
(e.g. City of Wpg, Town of Arborg, RM of Morris, Peguis First Nation)
Address of Damaged
Property*:
(e.g. 123 Main St., NE 2-34-1W, Lot/Blk/Plan or for First Nation communities: unit #)
Please check the type of application. Indicate the types of damages and / or losses incurred.
Residential:
Commercial: Farm
Business
Non Profit Organization
Briefly describe the damages and / or losses
Have you reported these losses and damages
to your insurance company?:		 Yes
No

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