Warranty Request FormPlease enable JavaScript in your browser to complete this form.Date: *Invoice Number: *Customer Name *FirstLastContact Name *FirstLastContact Phone * and unit Phone Contact Email *Stock / part number and serial number if reman:*** NOTE: If the serial number is not on your invoice, it will be stamped on the part itself and/or noted on the container the part was provided in.Vehicle Year/Make/Model: *Vehicle VIN: *Type of Part: *Date of Install:Name of Repair Shop: **** NOTE: Please include a copy of the invoice from the repair shop for the original install.Repair Shop Invoice * Click or drag files to this area to upload. You can upload up to 3 files. Allowed file types: .png, .gif, .jpg, .doc, .pdf. Up to 3 files allowed. Pictures of the Heat Tabs * Click or drag files to this area to upload. You can upload up to 3 files. Allowed file types: .png, .gif, .jpg, .doc, .pdf. Up to 3 files allowed. Miles at time of purchase: *Current Miles: *Codes present (if applicable):Issue with old unit (if applicable):Complaint summarized in a few sentences: *Pictures or videos: Please provide photos and videos of the parts, showing the issues / defects. * Click or drag files to this area to upload. You can upload up to 5 files. **** Incomplete forms and lack of information may delay the process.Allowed file types: .png, .gif, .jpg, .pdf, .mpg, .mov, .wmv Up to 5 files allowed. Submit
