ONLINE CLAIMS FORM
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Residential Claim Form
 
 
 
Is the product installed or partially installed?*
Is this Magnolia home ?
Is this product needed immediately to continue the job?*
 
CLAIMANT CONTACT INFORMATION
 
Legal Claimant Name(s)*
 
Site Address*
 
City*
 
Country*
 
State/Province*
 
Zip/Postal Code*
 
Primary Phone*
 
    (Enter number as 10 digits with no dashes or spaces, ex. 9999999999)
Alternative Phone
 
Email Address*
 
Verify Email*
 
JH Rep Email
 
MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
Address
City
Country
State/Province
Zip/Postal Code
 
PRODUCT INFORMATION
Please select the type of Hardie product(s) that are included in your warranty claim*
    
    
    
 
Product Size
 
Product Texture
 
 
 
# of Pieces Affected*
 
Year of Installation*
 
 
EXPLAIN CONCERN:*
 
 
 
 
 
RETAILER INFORMATION WHO SOLD THE MATERIAL (IF AVAILABLE)
Retailer Name
 
City
 
Country
 
State/Province
 
Phone
 
   (Enter number as 10 digits with no dashes or spaces, ex. 9999999999)
 
Year of Purchase
 
 
CONTRACTOR INFORMATION (IF AVAILABLE)
How was your Hardie/Cemplank product installed?
 
Contractor/Builder Name
 
 
UPLOAD CLAIM DOCUMENTS
(Include elevations pictures of each side of the house and close up of issue)
(James Hardie will accept a spec sheet, contractor proposal or letter from Builder)
*(Document such as tax bill, home insurance bill, deed, etc., that confirms you are the current and original first transferee. Document must show chain of custody of the home since purchase and installation of the James Hardie product)
 
CERTIFICATION OF ACCURACY
By clicking the Submit My Claim button below, I certify that to the best of my knowledge, information, and belief, the information on this concern form is true and correct.