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Company Name
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Address
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Address Line 1
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Name
*
First Name
*
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*
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*
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P.O. #
*
Product SKU #
*
Please describe in detail the nature of the claim
*
Date of Installation
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Year
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Date Door Finished
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Month
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Day
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Year
18
19
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28
Exact Install Door Height
*
Exact Install Door Width
*
Date Shipment Received from GlassCraft
*
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Month
01
02
03
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Day
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Year
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Was door or entryway factory finish or unfinished?
*
Factory Finished
Unfinished
Yes, Field Finished
• Type or brand of finish applied used: • The number of coats of finish applied:
Was finish applied to:
Door Edges
Top of the door
Bottom of the door
Check All
(Multiple Choice)
Overhang: Roof Overhang Distance in Inches
Overhang: Elevation in Inches
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