WARRANTY CLAIM FORM

IMPORTANT

1. Claim must be Submitted Within 30 Days of Failure.
2. Fill out One Claim Form for Each Unit.
3. Hold Parts at Dealer for Disposition Instructions.

 Form Number:
3535
Date:

Filled Out By:

Email Address:

Dealer Account Number:
Distributor or Dealer Name:
Address:
 City:
 State:
 Zip:
Customer Name:
Address:
 City:
 State:
 Zip:
BASE UNIT OR ATTACHMENT THAT FAILED
Model:
 Serial No:
 Date of Purchase:
 Date of Failure:
 Acres/Hrs Operated:
Tractor Make & Model:
 Date of Repair:
 Attachments Added:
DESCRIPTION OF FAILURE/REASON FOR CREDIT (DO NOT SAY DEFECTIVE).
Dealer Signature: By checking this box the dealer verifies the above information.
PARTS REPLACED (ITEMS CHECKED MUST BE RETURNED TO FACTORY). COMPANY USE ONLY
Quantity: Part No: Description: Dealer Cost: Warranty Approved:
Amount:
     
     
     
     
     
     
     
     
     
Warranty
Labor
Hours/Description
Rate
Total

Return Parts By:
UPS
Commercial Carrier
Company Truck
 
 
 
 
 
   
Total Labor
Allowance
Explain & Attach Receipts for "Other Credits"
Other Credits
 
Total
Total Parts:
Total Labor & Other Credits
Total Credits
 

 

 
 
Claim Approved
Claim Pending Return & Inspection
Claim Denied
IMPORTANT:Rankin Equipment Co. must be contacted prior to any warranty work being performed for pre-approval. Claim must be submitted within 30 days of failure.