Homeowner Notice Questionnaire

Please fill out the questionnaire below as accurately as you can. Your time in responding is greatly appreciated. Not returning this form may result in a delay in rendering a coverage determination.

Homeowner Notice Questionnaire (Builders)

"*" indicates required fields

1. Full Name*

2. Did you communicate with your builder during the first and/or second year of the warranty coverage period regarding concerns related to the current condition of your home?*

2a. How was the builder notified?*

2b. Verbally - Date(s) of Notification*

2c. Verbal Notification*

2d. In Writing - Date(s) of Notification*

Please provide copies of ALL written documentation to RWC.

3. In the first and/or second year of the warranty coverage period, did you notice symptoms or concerns related to the current condition of your home?*

3a. What did you observe & when did you notice these issues?*

4. During the life of the home, is there a time period that your home was vacant?*

4a. Please provide date(s) of vacancy and reason for vacancy, including forclosure details if applicable.*

5. During the life of your home, did you experience a flood?*

5a. Please provide the date(s) the flood occurred and any loss or damage that resulted from the flood, and any claims made and coverage provided for this home, including any reports obtained.*

6. Please identify and list with reasonable specificity any doors or windows that can only be opened or closed with force because they are binding against the frame or egress doors that do not lock properly.*

7. Have you had any plumbing testing performed at your home (water, sewer, sprinkler system, or pool)?*

8. In addition to the above information, RWC is requesting the following information to assist us in investigating your request for warranty performance. Please furnish us with the following:

- Any available photographs or videos of the defect(s)
- Any inspection, geotechnical, or engineering reports in your possession. (If you have not had any inspections made, you are not required to obtain one).
- Any estimates or invoices for repairs or permanent improvements to your residence. (If no estimates have been made, you are not required to obtain any).
- All claims made against your homeowner's insurance (for this residence) including any reports and coverage decisions by the carrier.

When submitting your responses to RWC, you are acknowledging that you have provided RWC with the requested information to the extent you possess the information or can readily obtain the information

Phone

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Homeowner Notice Questionnaire

Homeowner Notice Questionnaire (Builders)

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