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BUYERS ENROLLMENT FORM
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How do I enroll electronically?

Step 1 - Complete the enrollment form below. Be sure to select the protection you want.

Step 2 - Please double-check your information before submitting your enrollment.

Step 3 - Submit the form when finished.

Buyer Data
  Buyer’s Current Mailing Address (Old Home)  
  Name:
(First/Last)		  
  Address:  
  City:  
  State:   Zip:  
  Phone:  
  Buyer’s New Mailing Address (New Home)  
  Address:
  
  City:  
  State:   Zip:  
  Phone:
(if available) 		 
  Address of Residence Protected by this Plan
(if different from the Buyer’s New Mailing Address above)		  
  Property address:  
  City:  
  State:   Zip:  

Closing Information
  Company:  
  File #:  
  Phone number:  
  Fax number:  
  Escrow officer:  
  Closing date:
  
    (This is the date your protection starts.)  

Agent Data
  MLS Transaction number:  
  Sales associate name:  
  Office name:  
  Agent’s phone number:  
  Agent’s email address:  

Standard Protection
  Select protection plan

• Central Forced Air Heating and Cooling System
• Water Heater
• Dishwasher
• Range/Oven/Cook Top
 

Optional Appliance Protection
 
  3 Months 6 Months 1 Year
Refrigerator   $18   $36   $72
Washer and Dryer   $27   $54   $108
Attic Fan   $12   $24   $48
Microwave   $12   $24   $48
Trash Compactor   $12   $24   $48
Second Heating/Cooling System   $69   $138   $276
Second Water Heater   $12   $24   $48
Boiler Heat instead of Forced Air   $30   $60   $120
 

Optional Wiring and Plumbing Protection
 
  3 Months 6 Months 1 Year
Wiring and Plumbing Protection   $36   $72   $144
 

Payment
  Is this warranty being paid for out of the closing proceeds, or is the Realtor buying this warranty as a gift for the new homeowner?  
 
If it is paid out of the closing proceeds, please make sure the closing office gets a copy of the enrollment page from the CAP brochure.

If a gift, CAP will email or phone the Realtor with the total due and ask for the method of payment the Realtor will use to pay for the warranty. 		 

Any questions or problems, please call toll free 800-978-2022.