dealer form

warranty

HOME: SUPPORT: CONTACT: WARRANTY APPROVAL REQUEST FORM

ARIES Model/Serial No.:*
Claim Number
Date of Failure*
Date Equipment Placed in Service*
Dealer Name*
End User*
Address*
Repair Tech Notes*
Accepted file types: doc, docx.
Quantity ARIES Part # Description Unit Price Total Amount
Labor Hours*
Labor Rate*
Labor Total Cost
Shipping Cost*
Parts Cost
Total Cost of Parts, Shipping & Labor
OTHER CREDIT REQUESTED / COMMENTS
Name of Person Filing Claim*
Phone*
Date*
Additional Documentation
Drop files here or
Accepted file types: jpg, png, gif, pdf, doc, docx.
Phone
This field is for validation purposes and should be left unchanged.

Quantity	ARIES Part #	Description	Unit Price	Total Amount