PS - Home Warranty Claim CONTROLLERS arrowup6 ACTIVE STATUS * CONTACT ID * CONTACT EID * CLAIM ID * BILLING STATUS * Enter Your Email Address * Select the warranty address * If blank, ensure the correct email address is used. Select your warranty * If blank, ensure the correct email address and warranty address is used. Contract ID * WARRANTY EXPIRATION DATE * Co-Payment Fee * $ ITEM DETAIL SERVICE ITEM * What is needing serviced (ie. Water Heater, Ceiling Fan, etc.)? One item per claim. Brand Model Number Explain what the problem is * Upload photos if available Drop a file here or click to upload Choose File Maximum file size: 262.14MB BILLING Customer First Name * Customer Last Name * Billing Email * Credit Card Number for Service Charge * Credit Card Billing Address * Credit Card Billing Address Credit Card Billing Address Credit Card Billing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Credit Card Billing Address By submitting this claim request, you agree to the terms and conditions as stated in your service contract. $75.00 will be collected today for the service call. If the item submitted is not covered under your service contract a full refund of the $75 co-pay will be provided. This fee only covers the co-pay. Any haul off fees, consumable fees (filters, refrigerant, etc.) are extra and will be collected by the technician at time of service. * signature keyboard Clear PLEASE SIGN/TYPE YOUR NAME Submit Warranty Claim If you are human, leave this field blank.
