Star Plan Warranty Application

Please complete the form below and submit.

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Covered Items
Seller
3 Star
4 Star
5 Star
Plan Pricing
Included when selected
$369
$ 389
$ 389
Service Fee
$ 75
$ 55
$ 55
$ 75
Air Conditioning
YES
YES
YES
YES
Heating
YES
YES
YES
YES
Ductwork
YES
YES
YES
YES
Plumbing System
YES
YES
YES
YES
Electrical System
YES
YES
YES
YES
Water Heater
YES
YES
YES
YES
Dishwasher
YES
YES
YES
YES
Garbage Disposal
YES
YES
YES
YES
Built-In Microwave
YES
YES
YES
YES
Oven/Range/Cooktop
YES
YES
YES
YES
Range Exhaust Fan
YES
YES
YES
YES
Kitchen Refrigerator
YES
YES
YES
YES
Bathroom Exhaust Fan
YES
YES
YES
YES
Whirlpool Bathtub
YES
YES
YES
YES
Toilets
YES
YES
YES
YES
Built-In Trash Compactor
YES
YES
YES
YES
Ceiling Fans
YES
YES
YES
YES
Freon Recapture
---
---
YES
YES
Sump Pump
---
 
---
 
YES
YES
Permits
---
 
---
 
YES
YES
Removal of Existing Units
---
---
YES
YES
Central Vacuum
---
OPTIONAL
YES
YES
Garage Door Opener
---
OPTIONAL
YES
YES
Washer/Dryer
---
OPTIONAL
OPTIONAL
YES
Roof Leak Repair
---
OPTIONAL
OPTIONAL
YES
Warranty Information
*Required    
     
Warranty Buyer Type Seller   Buyer  
Warranty Plan (not for seller)

3 Star 4 Star 5 Star

 
Coverage Options (not available to sellers)
  Options
3 Star
4 Star
5 Star
               
  Seller Coverage
Covered
Covered
Covered
  Stellar Package
$ 50
$ 50
$ 50
  Roof Leak Repair
$ 75
$ 75
Covered
  Central Vacuum
$ 25
Covered
Covered
   
  Garage Door Opener
$ 25
Covered
Covered
   
  Well Pump
$ 75
$ 75
$ 75
   
  Washer/Dryer
$ 50
$ 50
Covered
   
  Septic
$ 50
$ 50
$ 50
   
  Swimming Pool / Spa
$ 150
$ 150
$ 150
   
   
   
         
         
Owner Information
Full Name*      
Phone Number*      
Property Address*      
City*      
State*      
Zip*      
         
Property Information
Year Home was built*      
Sq. feet      
Type of Construction      
         
Broker Information
GHW Broker #      
Broker Firm Name*      
Broker Firm Phone*      
Agent's Name*      
Agent's Phone*      
E-mail Address      
         
Closing Information
Closing Company*      
Closing Date*      
File No.      
Phone*      
Fax Number   (facilitates faster invoicing)  
         
         
Billing Information        
Pay at Closing        
Send In Check        
Pay by Credit Card        
       
         
*Required if paying by Credit Card    
         
Name on Credit Card *      
Credit Card Number *      
Credit Card Exp.      
CSV * Find My CSV   (May be 3 or 4 numbers on the back of your credit card)
Billing Address *      
Billing City *      
Billing State *      
Billing Zip *    
         
         
       
Comments        
         
By submitting this form I warrant, to the best of my knowledge, all systems are in good working order and I accept coverage.  
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*See current brochures and contract for specific coverage and limitations in your area.

© Globe Home Warranty Company. 2008




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