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, 134 KB). Fax, email or mail the completed form to EMO.

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

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

Applicant Information

Claim Type*:  Home 
 Farm 
 Business 
 Non Profit Organization
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)
Phone Number Home:
Phone Number Work:
Phone Number Cell:
Email Address:

Disaster and Damaged Property Information

Dates of damage*: From: (yyyy/mm/dd)
To:    (yyyy/mm/dd)
Type of Event:  
(e.g. flood, tornado...)
Address of Damaged
Property*:

(e.g. 123 Main St., NE 2-34-1W, Lot/Blk/Plan)
Local Authority of
Damaged Property*:
 
(e.g. City of Wpg, Town of Arborg, RM of Morris)
Tax Roll Number(s) of Damaged Property:
Please check the type of application. Indicate the types of damages and / or losses incurred.
Residential:  Homeowner 
 Tenant (claiming personal items only)
Damage to principal residence?
Yes  No
 Home is NOT habitable
Commercial:  My farm / business has gross annual revenues between $10,000 - $2,000,000 
 I am the day to day manager of my business 
 My damages are for crop losses only
Briefly describe the damages and / or losses. If flooding occured, include how the water entered the building.

Have you reported these losses and damages to your insurance company?

Yes
No
Briefly describe the status of your property insurance coverage related to the damages and / or losses.
Is the person filling out this application the
Registered Property Owner?:
Yes 
No

Comments

 to EMO or

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