Homeowner/Agent PICRA Submission Form
Homeowner's Phone Number
Homeowner's E-mail Address
Address of Property
Street Address Line 2
State / Province
Postal / Zip Code
Agent's Phone Number
Agent's E-mail Address
Is the home occupied or vacant?
If the home is occupied, who do you prefer we reach out to for scheduling inspections/repairs?
If the home is vacant, is there a contractor (not REIN) lockbox?
If the home is occupied, who do you prefer we reach out to for scheduling inspections/repairs? (Homeowner or Agent)
If the home is vacant, is there a contractor (not REIN) lockbox? (Yes or No)
If there is a contractor lockbox, what is the lockbox code?
What is the scheduled closing date on the home?
Any additional information you'd like to provide?
How did you hear about us?
Other (Please specify below)
If 'Other', please specify in box below.
Upload Home Inspection Report
Upload PICRA List
If you have any additional documentation or photos that you think may be useful for us to review, please upload them here:
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