Conciliation Request

I have read and understand the rules for conciliation. *

Rules for Conciliation 

First Name *

Last Name *

Email *

Phone *

Address Line 1 *

City *

State *

Enter required value

Name of your builder/remodeler *

Year Built *

Date of possession/closing *

Home still under construction? *

Enter required value Yes No

Have you reported your complaint to the builder? *

Enter required value Yes No

Is money being withheld from the builder? *

Enter required value Yes No

Is your house covered under an insured warranty such as 2/10 or OBW? *

Enter required value Yes No

Is your warranty expired? *

Enter required value Yes No

Contract *

Upload your contract between you and the builder. Including your warranty contract.

20MB max

Upload documents

If your one-year warranty has expired, you must furnish written documentation along with this form showing that the builder was made aware of the issues you are submitting on this form within the warranty period.

20MB max

Itemized List of Issues *

20MB max

Non-binding *

I understand that conciliation is a non-binding process by which homeowners and BIA builders and remodelers resolve disputes/reach settlements without litigation. The conciliators work on a volunteer basis. Thus, I agree to indemnify and hold harmless the BIA and its officers, directors, committee members, agents, employees, and conciliators from and against claims, damages, losses, and expenses, including but not limited to attorneys' fees or incidental damages, arising out of or resulting from the negligence or misconduct in connection with their work, actions, decisions, inquiries, and/or recommendations associated with the conciliation process.

Enter required value Yes

Credit Card authorization *

I agree to have my card charged the contracted fee amount after the 30-day period and request to proceed with the conciliation process. If you do not know your fee amount, please refer to the contract that you provided to us.  

Enter required value Yes

Credit Card Number *

Expiration Date *

CVC Code *

Zip Code *