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Homeowner Information
Full Name *
*
Property Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Phone Number
*
Email Address
*
Warranty Claim Details
Description of the Issue
*
Location of the Issue
*
Date the Issue Was First Noticed
*
MM slash DD slash YYYY
Photos of the Problem
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Max. file size: 100 MB.
Project Information
Date of Completed Repairs
*
MM slash DD slash YYYY
Original Project Manager (if known)
Access and Scheduling
Preferred Time for Follow-Up Contact:
*
Preferred Time for Follow-Up Contact *
Morning
Afternoon
Evening
Home Access Availability (Date)
*
MM slash DD slash YYYY
Home Access Availability (Time)
*
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
Acknowledgements
Authorization to Contact:
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I understand and authorize Golden Coast Construction to contact me within (4) business days regarding this claim.
Accuracy Confirmation:
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I confirm that the information provided is accurate to the best of my knowledge.
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