Required fields are in red

Homeowner/Property Information:
  Address Line #1:
Address Line #2:
  City, State, Zip Code:
Telephone Number:
  Email Address:
Cellular Number:
  Warranty Serial #:
Date that you first became aware of the possible water intrusion or mold-like substance:
Have you contacted your builder yet?   Yes     No

    If not, please notify them immediately.

Suspected moisture intrusion or mold like substance
Please provide a detailed description:

Customer's Responsibilities
Upon becoming aware of a moisture intrusion problem in your structure, customer should submit this completed form to Microbe Guard Inc and customer should take immediate action to stop the source of moisture. In most cases, removing any standing water and placing a dehumidifier in the wet areas will substantial reduce any possible damage to you structure.
Microbe Guard's Responsibilities
Microbe Guard or its authorized agent will contact you immediately upon receiving this completed form. We will fully investigate the circumstances of this claim and issue a written report to the customer and builder upon completion of the investigation. Microbe Guard will carry out all responsibilities outlined in its warranty for its required performance of said warranty resulting from this claim.