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Notification Form Submission
Please refer to the report number in all correspondence.
Name
Report Number
Address
Inspection Date
Phone (Home)
Phone (Work)
Date Problem Reported:
Date Notification Mailed
Date of Closing
Date You Occupied Home
Unoccupied Dates
Date(s) you first noticed the problem(s)
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?
--
yes
no
If yes the amount (USD)
Did you perform a pre-settlement walk-thru?
--
yes
no
If yes, date of walk-thru
Persons present for walk-thru
Did you have a termite inspection?
--
yes
no
Did you have a stucco inspection?
--
yes
no
If you had additional inspections please list them here with dates performed
Did you purchase a home warranty?
--
yes
no
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.
yes
Send
