Fortified Certificate Renewal Form

First Name

Last Name

Email Address

Phone Number

Street Address

City

State

Zip Code

FEH ID Number from your existing Certification (if known)

Has any portion of the roof cover (shingles, metal, tile, etc.) on your home been damaged, repaired, or replaced in the last 5 years? Has any portion of the roof cover (shingles, metal, tile, etc.) on your home been damaged, repaired, or replaced in the last 5 years?UnknownYes, partial roofNoYes, the entire roof

Have any of the systems listed been damaged, repaired, replaced or upgraded in the last 5 years? Select all that apply. * Have any of the systems listed been damaged, repaired, replaced or upgraded in the last 5 years? Select all that apply. * Attic Ventilation, Roof Vents, or Soffits Window or Door Shutter Systems Windows and Doors Garage Doors Unknown None of the above

Have there been any additions to the home in the last 5 years? Have there been any additions to the home in the last 5 years?YesNoUnknown

Has any space been enclosed or conditioned in the last 5 years? * Has any space been enclosed or conditioned in the last 5 years? *YesNoUnknown

How did you hear about us? How did you hear about us?Online search engine (e.g., Google, Bing)Social media platform (e.g., Facebook, Instagram, LinkedIn)Referral from a friend, family member, or colleagueAdvertisement (e.g., online banner ad, magazine ad, radio ad)Postcard / MailerOther

Please tell us how you heard about us

Additonal Notes or Comments