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Please complete the following information.
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Step
1
of 2
Property Address
*
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Heating & Air Conditioning
*
Single Unit
Dual Zone
Three Zone
Note: If you have two thermostats you have dual zone. It may be a split single system or two separate systems.
Age of HVAC system
Age of 2nd HVAC system
Age of 3rd HVAC system
Heat Fuel Source
*
Electric
Natural Gas
Propane tank
Heat Type
Forced air
Heat pump
HVAC Service Agreement in place?
Yes
No
Name of service provider
Number of Water Heaters
*
Single Unit
Two Units
Water Heater fuel source
*
Electric
Gas
Apollo
Tankless
Age of water heater(s)
Location of water heater
*
Fireplace
*
Yes
No
Fireplace type
Wood burning
Gas
Electric
Do you use it?
Yes
Rarely
No
When was last time the fireplace was inspected?
Next
What year was your roof installed?
*
Does it have a warranty?
15 year
20 year
25 year
30 year
Who was installer?
What type of foundation do you have?
*
Slab
Crawlspace
Unfinished Basement
Finished Basement
Partially finished basement
Do you have a home warranty in place?
*
Yes
No
Name of warranty company
Do you have a termite bond in place?
*
Yes
No
Name of termite company
Is it transferrable?
Yes
No
Not sure
Transfer fee
Do you have a security system?
*
Yes I have an active system
It is wired but not active
No
Name of security company
Cost per month
It is transferrable?
Yes
No
Do you have an assigned mailbox number?
*
Yes
No
Assigned mailbox number
Do you have an assigned parking space?
*
Yes
No
Assigned space #s
Please list your maintenance upgrades (ex: roof, water heater, HVAC, etc.).*
*Please include the year that the work was done
Please list your cosmetic upgrades (ex: countertops, light fixtures, paint, carpet, etc.).*
*Please include the year that the work was done
Phone
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