This Disaster Planner Belongs To :

_______________________
_______________________
Address:
_______________________
_______________________
_______________________
Phone:
_______________________

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Family Information

Name
_______________________
Birthdate
_______________________
Race
_______________________
Eye Color
_______________________
Height and Body Build
_______________________
Hair Color
_______________________
Notable Features (birthmark, tattoo, scar)

Name
_______________________
Birthdate
_______________________
Race
_______________________
Eye Color
_______________________
Height and Body Build
_______________________
Hair Color
_______________________
Notable Features (birthmark, tattoo, scar)

_______________________

_______________________

_______________________

Medical Conditions
_______________________

Medical Conditions
_______________________

Medical Conditions
_______________________

_______________________

_______________________

_______________________

_______________________

Work/School Phone #

Work/School Phone #

_______________________

_______________________

Record Mobile Phone

Record Mobile Phone

_______________________

_______________________

Attach Family Photo or a

Photo of Each Family
Member

Attach Family Photo or a

Photo of Each Family
Member

Contact Information of
Nearest (Next of Kin)
Relative

Contact Information of
Nearest (Next of Kin)
Relative

_______________________

_______________________

_______________________

_______________________

Other Information

Other Information

_______________________

_______________________

_______________________

_______________________

Name
_______________________
Birthdate
_______________________
Race
_______________________
Eye Color
_______________________
Height and Body Build
_______________________
Hair Color
_______________________
Notable Features (birthmark, tattoo, scar)

_______________________
_______________________
Work/School Phone #
_______________________
Record Mobile Phone
_______________________
Attach Family Photo or a
Photo of Each Family
Member
Contact Information of
Nearest (Next of Kin)
Relative
_______________________
_______________________
Other Information
_______________________
_______________________

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EMERGENCY CONTACT
Neighborhood Contact
Name ________________________________________________________________________
Address ______________________________________________________________________
Relation ______________________________________________________________________
Phone ________________________________________________________________________
Email ________________________________________________________________________
Out of Neighborhood Contact
Name ________________________________________________________________________
Address ______________________________________________________________________
Relation ______________________________________________________________________
Phone ________________________________________________________________________
Email ________________________________________________________________________
Out of State Contact
Name ________________________________________________________________________
Address ______________________________________________________________________
Relation ______________________________________________________________________
Phone ________________________________________________________________________
Email ________________________________________________________________________

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important numbers
Attorney Name ___________________________ # ___________________________
Doctor Name ___________________________
Whos Doctor _______________________ #_________________________
Doctor Name ___________________________
Whos Doctor _______________________ # ________________________
Doctor Name ___________________________
Whos Doctor _______________________ # ________________________
Local Hospital Main # _______________________________________
Electrician Name ___________________________ # ___________________________
Home Insurance Company____________________________ # __________________________
Car Insurance Company _____________________________ # ___________________________
Health Insurance Company __________________________ # ___________________________
Local Municipality Phone #(city hall, town clerk) _________________________________
Plumber Name ___________________________ # ________________________________
Poison Control ______________________________________
Alarm Company ____________________________ # ____________________________
Bank Contact Name ____________________________ # __________________________
Emergency Contact ___________________________ # _____________________________
Veterinarian Name __________________________ # ______________________________
Local Office of Emergency Management _________________________________
Fire Department ____________________________________________________
Light Company Phone ____________________________________
Water Company Phone ___________________________________
Gas Company Phone _____________________________________
Kennel Phone # _____________________________________
Police Station # _____________________________________
Number for Local Red Cross ______________________________
Number for FEMA ______________________________________

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INSURANCE Information
Life
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________
Medical
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________
Home
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________
Car
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________
Other_____________
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________
Other ____________
Policy Holder _________________________
Policy Number ________________________
Insurance Company Phone Number ___________________________

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FAMILY Records
Family Records - includes documents that are important and hard to replace. Each of these items
should be copied. We advise that originals are kept in a safety deposit box or a safe in the home.
Before it is stored it should be placed in a watertight container such as Doc-u-Keeper. These
items include:
Copy of Drivers License
Birth Certificate and Marriage Certificates and Death Certificates
Social Security Cards
Medical and Dental Cards
Insurance Policies with Information
Passports
Diplomas and Degrees
Home Mortgage Documents or Deeds
Vehicle Titles and Registration
Home Inventory
Income Tax Records(first two pages)
Stock Certificates/ Bonds/ Notes
Citizenship and Naturalization Papers
Credit Card/ Loan Contact Information
Wills and Legal Documents

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AREA RISK
List the Top Disasters You Regularly Have In Your Area
1.__________________________
2. _________________________
3. _________________________
4. _________________________
5. _________________________
List 3 Designated Reunion Location
In Home Location _____________________________________
In Neighborhood Location ______________________________________
Out of Neighborhood Location(local park, school) __________________________________

Shelter in Place
Stay in an interior room of your home
Which room ______________________________
Move your supplies to this room
Camp out until the disaster is over and it is safe

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floor plan
Create a floor plan. Create a key and mark in the locations of your emergency supplies, your
utilities, your safety equipment, and exits.

First Floor

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Second Floor

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disaster PLANS
Make a Plan for the Top 5 Disasters You are at Risk
Disaster _____________________________________
Before a Disaster we will:
Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.____________________________________________________________________________
During a Disaster we will:
Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
After a Disaster we will:
Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________

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Disaster ___________________________
Before a Disaster we will:
Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.____________________________________________________________________________
During a Disaster we will:
Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
After a Disaster we will:
Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________

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Disaster ___________________________
Before a Disaster we will:
Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.____________________________________________________________________________
During a Disaster we will:
Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
After a Disaster we will:
Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________

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Disaster ___________________________
Before a Disaster we will:
Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.____________________________________________________________________________
During a Disaster we will:
Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
After a Disaster we will:
Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________

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Disaster ___________________________
Before a Disaster we will:
Example.: 1. Check Supplies 2. Inspect Home 3. Assess Situation & Decide Whether to Evacuate
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6.____________________________________________________________________________
During a Disaster we will:
Example. 1. Meet at Reunion Location 2. Stay in Safe Room 3. Listen to NOAA Radio
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
After a Disaster we will:
Example: 1. Check on Loved Ones 2. Take Photos of Damage 3. File a Claim with State Farm
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________

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EVACUATION PLAN
Where will you go (Option 1):

_________________________________________________________________
_________________________________________________________________
Where will you go (Option 2):
_____________________________________________________________________________
_____________________________________________________________________________
Create an action plan to complete the steps below:
List of What to Pack
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
List to Get Your Vehicle Ready
_______________________________________
_______________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________

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List to Secure Your Home

________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
________________________________________
Returning Home
When it is safe, return home
Document any damage (with pictures also)

Home Inventory
Keep a copy of your home inventory in one or all of your disaster planners.

VEHICLE INFORMATION
YEAR

MAKE

MODEL

LICENSE
PLATE

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VIN #

Passwords and PINS

Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________
Account: _________________________________________________
Account User Name: _______________________________________
Account Password: _________________________________________

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PETS
Name __________________________________
Species _________________________________
Breed __________________________________
Description ______________________________
Special Needs ____________________________
Veterinarian ______________________________
Immunization Records
Photo
Name __________________________________
Species _________________________________
Breed __________________________________
Description ______________________________
Special Needs ____________________________
Veterinarian ______________________________
Immunization Records
Photo
Name __________________________________
Species _________________________________
Breed __________________________________
Description ______________________________
Special Needs ____________________________
Veterinarian ______________________________
Immunization Records
Photo

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disaster supplies inventory

Inventory your disaster supplies by recording the location, the item, and the amount of your
disaster supplies.

LIVING ROOM

KITCHEN

GARAGE

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mASTER BEDROOM

_________________________

____________________________

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