Warranty claim form

For any warranty to be valid the vehicle in question must be registered

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Warranty Claim Form

Warranty Claim Number: (Enter unique Claim No) *

Spares Account No: *

Your Name: *

Your Company Name: *

Your Email: *

Vehicle Owned by: *

Owners Address: *

Type of Sweeper: *

EQ Number (Serial No.): *

Registration Number: *

Date in Service: *

Hour Meter Reading: *

Speedo Reading: *

Date of Failure: *

Date of Repair: *

Failure Symptom: *

Engineers Description: *

What Has Been Done to Repair?: *

Part 1

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 2

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 3

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 4

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 5

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 6

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 7

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Part 8

Part Number:

Description:

Airway Bill No:

Quantity: *

Invoice / Delivery Note No: *

Time Taken to Resolve Problem

On Site Time Hours:

Travel Time Hours:

Distance Travelled Miles / KMs:

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