MI Windows & Doors 7555 E. State Route 69 Prescott Valley, Arizona 86314 DEALERS FORM FOR SERVICE REQUEST Customer Care # 1-888-417-1162 Please Fax Form to 928-759-0913 Click the link for a printable version in PDF form: Homeowner Warranty Claim Form
Homeowner Information
** First Name:
** Last Name:
** Street:
PO Box / Suite:
** City:
** State:	Select One AA AK AL AR AZ BB BH CA CA01 CA02 CA03 CA04 CA05 CA07 CA08 CA09 CA10 CA11 CA12 CA13 CA14 CH01 CH02 CH03 CH04 CH05 CH06 CH07 CH08 CH09 CH10 CH11 CH12 CH13 CH14 CH15 CH16 CH18 CH19 CH20 CH21 CH22 CH23 CH24 CH25 CH26 CH28 CH29 CH30 CH31 CH32 CH33 CN CO CT DC DE FL GA HI IA ID IL IN IT KS KY LA MA MD ME MI MN MO MS MT MX01 MX02 MX03 MX04 MX05 MX06 MX07 MX08 MX09 MX10 MX11 MX12 MX13 MX14 MX15 MX16 MX17 MX18 MX19 MX20 MX21 MX22 MX23 MX24 MX25 MX26 MX27 MX28 MX29 MX30 MX31 MX32 NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY
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**Homeowner Phone:
**Contractor Name:
**Contractor Phone:
Dealer Information
**Dealer Name:
** Email Address:
** City:
** State:	Select One AA AK AL AR AZ BB BH CA CA01 CA02 CA03 CA04 CA05 CA07 CA08 CA09 CA10 CA11 CA12 CA13 CA14 CH01 CH02 CH03 CH04 CH05 CH06 CH07 CH08 CH09 CH10 CH11 CH12 CH13 CH14 CH15 CH16 CH18 CH19 CH20 CH21 CH22 CH23 CH24 CH25 CH26 CH28 CH29 CH30 CH31 CH32 CH33 CN CO CT DC DE FL GA HI IA ID IL IN IT KS KY LA MA MD ME MI MN MO MS MT MX01 MX02 MX03 MX04 MX05 MX06 MX07 MX08 MX09 MX10 MX11 MX12 MX13 MX14 MX15 MX16 MX17 MX18 MX19 MX20 MX21 MX22 MX23 MX24 MX25 MX26 MX27 MX28 MX29 MX30 MX31 MX32 NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY
**Phone:
**Reference PO#:
**Reference MI SO#:
**Date Purchased:
**Contact Name:
**Describe product defect or problem:
**Inspected by Dealer:
**Date:
**Inspected by Contractor:
**Date:
**Inspected by MIWD:
**Date:
Line Series Qty Unit Size Color Glass Type Grid Style Other 1 Select One Unknown 090 0A0 1255 1280 1450 1480 1555 1650 1665 1675 1680 1695 185 188 340 347 350 3500 3540 3580 360 370 380 390 390FR 420 430 4300 4340 440 5500 5610 570 570T 5800 5900 5A0 5A5 6000 615 615HP 620 625 625HP 6A0 740 825 8500 865 875 910 9540 9555 9660 9770 9880 9990 BM3L BMAWN BMCASE BMDH BMDS BMPDF BMPDS NC3L NCAWN NCCASE NCDH NCPDF NCPDS NCSH SE-9555 TX 3000 WC355 Clear Loe Loe Tint Lami Temp 2 Select One Unknown 090 0A0 1255 1280 1450 1480 1555 1650 1665 1675 1680 1695 185 188 340 347 350 3500 3540 3580 360 370 380 390 390FR 420 430 4300 4340 440 5500 5610 570 570T 5800 5900 5A0 5A5 6000 615 615HP 620 625 625HP 6A0 740 825 8500 865 875 910 9540 9555 9660 9770 9880 9990 BM3L BMAWN BMCASE BMDH BMDS BMPDF BMPDS NC3L NCAWN NCCASE NCDH NCPDF NCPDS NCSH SE-9555 TX 3000 WC355 Clear Loe Loe Tint Lami Temp 3 Select One Unknown 090 0A0 1255 1280 1450 1480 1555 1650 1665 1675 1680 1695 185 188 340 347 350 3500 3540 3580 360 370 380 390 390FR 420 430 4300 4340 440 5500 5610 570 570T 5800 5900 5A0 5A5 6000 615 615HP 620 625 625HP 6A0 740 825 8500 865 875 910 9540 9555 9660 9770 9880 9990 BM3L BMAWN BMCASE BMDH BMDS BMPDF BMPDS NC3L NCAWN NCCASE NCDH NCPDF NCPDS NCSH SE-9555 TX 3000 WC355 Clear Loe Loe Tint Lami Temp 4 Select One Unknown 090 0A0 1255 1280 1450 1480 1555 1650 1665 1675 1680 1695 185 188 340 347 350 3500 3540 3580 360 370 380 390 390FR 420 430 4300 4340 440 5500 5610 570 570T 5800 5900 5A0 5A5 6000 615 615HP 620 625 625HP 6A0 740 825 8500 865 875 910 9540 9555 9660 9770 9880 9990 BM3L BMAWN BMCASE BMDH BMDS BMPDF BMPDS NC3L NCAWN NCCASE NCDH NCPDF NCPDS NCSH SE-9555 TX 3000 WC355 Clear Loe Loe Tint Lami Temp 5 Select One Unknown 090 0A0 1255 1280 1450 1480 1555 1650 1665 1675 1680 1695 185 188 340 347 350 3500 3540 3580 360 370 380 390 390FR 420 430 4300 4340 440 5500 5610 570 570T 5800 5900 5A0 5A5 6000 615 615HP 620 625 625HP 6A0 740 825 8500 865 875 910 9540 9555 9660 9770 9880 9990 BM3L BMAWN BMCASE BMDH BMDS BMPDF BMPDS NC3L NCAWN NCCASE NCDH NCPDF NCPDS NCSH SE-9555 TX 3000 WC355 Clear Loe Loe Tint Lami Temp