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Claim Form
DAMAGE & RETURN CLAIM FORM
Warranty Claims Number:
9850
Section I. General Information:
Today's Date
Contact Name
Dealer Name
Phone
Sales Order #
Email
Section II. Reason for Claim:
Wrong Product
Missing Parts/Hardware
Manufacture's Defect
Other
Section III. Freight Damage:
Claims must be filed within 15 business days from date of delivery. Pictures of damaged good and original cartons are required and must accompany your claim. Failure to include these items will cause delay or denial of your claim.
Freight Damage Noted Upon Arrival:
Was the Box Damaged?
Yes
No
Was Shipment Refused or Visible Damage?
Yes
No
Concealed Damaged:
Was Damage Noted on Bill of Lading?
Yes
No
Are Items Still in Original Packaging?
Yes
No
Section IV: Explanation and Photos:
Brief Explanation of Issue:
Select Photo(s)..
Max size: 15Mb per photo
Section V: Shipping of Replacements:
Original Address from PO
Different Address
Company Name
ATTN
Address Line 1
Address Line 2
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