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Customer Name
Customer Address(Required)

Punch List
Clear Signature
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I understand that the Service Scheduler Ryan (818.270.5691) will contact me within the next business day to schedule. The punch list is generally completed within 7 days. I authorize to charge the remaining balance to the card I have on file.
Clear Signature
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Consent
OFFICE USE: Please submit original form to Coordination Department. Upon request, a dual signed copy will be emailed to the Client.