Warranty Replacement Request Pipe Flashing Replace Request Form Person Requesting Replacement Company (if applicable) Contact phone Contact email Affected address City State Zip code Mailing address for replacements (If different from affected address) Mailing address for replacements Mailing city, state, zip code Date of installation (Or date of occupancy for new construction) Date of installation Number of replacement collars requested Color of original pipe flashing base: Size of original pipe flashing Company product was originally purchased from*: *For use by contractors – If you are the homeowner, list your roofing company or builder. Company product was originally purchased from Please include a photo of the house (showing the house number) House Number Photo Please upload a photo of at least one failed pipe flashing on the roof. Failed Flashing Photo Notes Submit