ELITE HOME BUILDERS LLC

• WARRANTY CLAIM FORM •

Homeowner Information:

First Name:

Last Name

Address of Property Covered:

Phone

Email:

Purchase Information:

Date of Closing (Home Purchase)

Are you the original homeowner?

Yes

No

Claim Information:

Date the Defect Was First Noticed:

Description of the Defect:

Area(s) of the Home Affected:

Have you previously notified Elite Home Builders LLC of this issue?

Yes

No

Emergency Issue?

Yes (e.g., burst pipe or other urgent matters)

No

Supporting Documents (Optional):

File Upload (JPG, PNG, MP4, PDF)

Homeowner Signature

By signing below, I acknowledge that I am the original homeowner and that this claim is being made within the terms of the warranty.

Signature