Client Verification
I verify that I am the client/purchaser of this property*
I verify that I read the entire inspection report when it was sent to me*
Contact Information
Name*
First Last
Email Address*
Phone Number*
Inspection Address*
Street Address City
Important Dates
Home Inspection Date*
MM slash DD slash YYYY
Closing Date*
MM slash DD slash YYYY
Possession Date*
MM slash DD slash YYYY
Date When You First Noticed the Issue*
MM slash DD slash YYYY
Date of Your Final Walkthrough Before Closing*
MM slash DD slash YYYY
Issue Details
Was the Issue Apparent at the Final Walkthrough?*
Have You Consulted With a Contractor On This Issue?*
What Did the Contractor Say About the Issue?
Upload Any Contractor Bids/Estimates Here
Drop files here or

Max. file size: 256 MB.
Was the Home Sold With a 1-Year Home Warranty in Place?*
What is the Name of the Home Warranty Company?
What Did the 1-Year Home Warranty Company Say About the Issue?
Was the Issue in the Seller's Disclosure Document?*
Upload a Copy of the Seller's Disclosure Here
Max. file size: 256 MB.
Upload a Copy of the Seller Request for Repairs Here
Max. file size: 256 MB.
Was the Home Ever Sold "As-Is"?*
Was the Home Ever Bank Owned?*
Do You Currently Occupy the Dwelling?*
What is the Issue You Are Experiencing?*
Upload Any Images of the Issue Here
Drop files here or

Max. file size: 256 MB.
How Would You Like the Issue Resolved?*
Signature*
Before You Hit Submit, Please Make Sure This Form is Completely Filled Out. Also, if You Have Not Contacted Your Home Warranty Provider, Home Owner’s Insurance, or Gotten Bids For Repairs From a Contractor Then it is Recommended That You Do So Before Submitting This Form. By Signing Above You Attest That the Above Information is True & Correct.

Client Verification

Contact Information

Important Dates

Issue Details