Electrical System Report Card

Use this branded field report on tablets or desktop. Fields are interactive and responses are organized for follow-up recommendations.

Please complete the highlighted required fields before submitting the report.

Customer Information

Name *

Customer name is required.

State *

State is required.

Street *

Street is required.

Zip Code *

Zip code is required.

City *

City is required.

Email Address *

A valid email address is required.

Main Electrical Service / Meter / Main

Approximate Age *

<5 5 10 20 30 40 50 60+

Please choose an approximate age.

Service Feed Type *

Underground Overhead

Please choose a feed type.

System Voltage *

120/240 OTHER

Please choose a system voltage.

Electrical Phase *

Single Phase Three Phase

Please choose the electrical phase.

Main Service Rating *

100A 125A 150A 200A 400A

Please choose the main service rating.

Bus Material *

Copper Bus Aluminum Bus

Please choose the bus material.

Wiring Type *

Copper Wire Aluminum Wire

Please choose the wiring type.

Insulation Type *

Cloth Rubber Plastic

Please choose the insulation type.

Kings Home Services Electrical System Report Card

Deficiency Summary for Customer Presentation

List the key deficiencies and recommended actions below. This section is designed to support a customer-facing review and estimate handoff.

Technician notes / location details:

Customer Authorization & Signature

I understand that this evaluation is performed with the intent to identify any possible electrical problems, but by no means carries any guarantees. No person or entity associated with our company nor the service representative performing the evaluation shall be held liable for any damages which may arise from any identified or unidentified electrical problems but shall be the sole liability of the undersigned.

Customer Signature *

Customer signature is required.

Date *

Date is required.

Technician / Advisor *

Technician / Advisor is required.

Job / Invoice # *

Job / Invoice number is required.

Kings Home Services Electrical System Report Card

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Electrical System Report Card

Electrical System Report Card

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Electrical System Report Card

Electrical System Report Card

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Electrical System Report Card

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Electrical System Report Card