PC068 1004 Print ROOFING INSTALLATION INFORMATION AND CERTIFICATION FOR REDUCTION IN RESIDENTIAL INSURANCE PREMIUMS NOTICE TO HOMEOWNER - insurance tx-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Name of Roofing Company' along with its 'Street Address', 'City', 'County', and 'Zip Code'. Ensure all details are accurate for proper identification.
3. Fill in the 'Phone' number and 'License Number' if applicable. This information is crucial for verification purposes.
4. Next, complete the section labeled 'Address of Residence'. Include the 'Name of Owner', both home and office phone numbers, as well as the full address including city, county, and zip code.
5. In the certification section, an authorized representative must sign and date the form. Specify the roof covering installed and its compliance with Underwriters’ Laboratory Standard 2218.
6. Select the appropriate impact resistance classification (Class 1 to Class 4) based on your roofing material. Provide details about the manufacturer, brand name, year manufactured, and labeling of products.
7. Finally, ensure that you check one of the options regarding labeling requirements before submitting. Remember to retain a copy for your records and send another to your insurance company.

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