Please refer to the report number in all correspondence.
Name*
Report number*
Full Address*
Inspection date*
Primary phone*
Secondary phone*
Date problem reported*
Date notification mailed*
Date of closing
Date you occupied home
Unoccupied dates start
Unoccupied dates end
Date you first noticed the problem*
Describe all problems*
If reported problem was noted during remodeling or decorating please explain:
Have You Had An Estimate Of The Cost To Correct The problems?* --YesNo
If yes the amount (USD)
Did you perform a pre-settlement walk-thru?* --yesno
If yes, date of walk-thru
Persons present for walk-thru
Did you have a termite inspection?* --yesno
Did you have a stucco inspection?* --yesno
If you had additional inspections please list them here with dates performed
Did you purchase a home warranty?* --yesno
Your homeowner insurance company*
Your homeowner policy number*
As a condition to processing this notification, I affirm that I have read and understand the terms of the Agreement for Home/Building inspection Services, the Inspection Order Agreement, and the Inspection Report including the Pre-settlement Walk thru sections. I agree to fulfill my obligations therein stated.
