Warranty Registration Form Warranty Registration Form "*" indicates required fields Please fill out this form completelyBuilding Owner* Building Street Address* City* State*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 PacificZip Code* Zip CodePhone*Email* Installation Contractor* Street Address* City* StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Zip CodeCBM Invoice#* Date Installation Completed* MM slash DD slash YYYY Account# Product Purchased* Color* Type Of Warranty Roofing Warranty Gutter Warranty Both Roofing and Gutter Warranty Roofing Warranties Gutter Warranties Roofing Warranties Gutter Warranties Select One* Commercial Residential Zincalume Select One* Residential or Commercial–Limited Lifetime Limited 25 Year Zincalume®/Galvalume® Is this roof located within 1,500 feet of a salt water environment?* Yes No Does the metal include a high-build primer?* Yes No Does the metal include a clear coat?* Yes No Steel roofing material installed within 1,500 feet of a salt water environment must include a high-build primer to qualify for the 15-year severe marine warranty. Aluminum roofing material installed within 1,500 feet of a salt water environment does not require a high-build primer to qualify for the 15- year severe marine warranty. Both steel and aluminum roofing materials installed within 1,500 feet of a salt water environment must include both a high-build primer and a clear coat to qualify for the 20-year severe marine extended warranty. Registrations must be received by Custom-Bilt Metals within 150 days of installation. Δ
