Contact Information:

Did you purchase home from developer?

Builder Name

If yes, when?

1. Are there leaks, moisture, mildew, water stains or other water damage visible inside the house:

If yes, where are they located and how many?

2. Are there visible cracks, splits, separations or bulging in the interior or exterior of your home:

If yes, please describe where they are located and how many. Please indicate size by including both length and width.

3. Are the sliding glass doors, entry doors, and windows hard to operate, latch or out of square:

If yes, which doors and windows?

4. Have you had problems with the plumbing:

If yes, please describe.

5. Have you had problems with the Heating/Cooling System:

If yes, please describe.

6. Have you had any problems with the decks/patios/stairways, etc. (i.e. ponding water, loose railings, dry rot, etc.):

If yes, please describe where and how many problems:

7. Have you had any problems with the roof: (i.e. water leaks, loose or broken tiles, defective gutters, etc.):

If yes, please describe where and how many problems:

8. Do you have any mold or mildew visible in your home:

If yes, please describe and note location.

9. Have you had any problems in the front, side or back yards: (i.e. ponding water, lack of drainage, sink holes, etc.):

If yes, please describe where and how many problems:

If you are experiencing any other problems or have other complaints, please describe below