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Warranty Claim
Fill out the form below to begin your warranty claim process. Fields marked with an
*
are required.
Contact Information
Distributor Name / Where purchased
*
Contact Name
*
Address
*
City
*
State/Province
*
Zip Code
*
Email Address
*
Phone
End User Company Name
End User Contact Name
Part Information
Part Number or Description
*
Reported Issue
*
Date On
*
Odometer On
*
Date Off
*
Odometer Off
*
Vehicle Year
Vehicle Make
Vehicle Model
Engine Fan Part # or Size (ex 9 blade - 30" diameter)
Your Reference # (optional)
Check this box if you're human
*