Service Request Form "*" indicates required fields Reference #Homeowner Name* First Last Homeowner Email* Homeowner Phone #*Homeowner Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contractor Name* Contractor Phone #*Distributor Name* Distributor Location* Approximate Installation Date* MM slash DD slash YYYY Product DescriptionSkylight Size* Number of Units* Type of Skylight* Fixed Vented Type of Roof* Pitched Roof Flat Roof Manual or Motorized* Manual Motorized Type of Motor* Solar HS Marvel Type of Glass* Clear Bronze Laminated Other Type of Shade* Manual Motorized No Shade Type of Shade Motor* Rechargeable Battery Solar with Battery Roof Pitch* # of Stories* Skylight Location* Description of Problem*Please Attach an Image of the Issue* Drop files here or Select files Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 50 MB. Required for accurate diagnosis and service.Please Attach Proof of Purchase*Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 50 MB.NameThis field is for validation purposes and should be left unchanged. Δ
