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Warranty Claim form

Warranty Claim form

ID :190523-40e657

You have to fill everything which marked with red!

  • Choose where you wish to send the items

  • BUYER
  • Name of inviduals, or the name of the Company

  • Adress, Country, Town, Street house Nr.

  • Phone number and /or E-mail address

  • Vehicle:
  • ex Skoda, Opel, Volkswagen

  • Exact type with parameters

  • ex. 1970

  • Give the model year

  • Chassis number must 17 character long!

  • Engine code / number:

  • Chose the type of the a fuel

  • Invoice parameters:
  • . . Dátum választás
  • Type here the Art. Nr form the Invoice for the Warranty

  • . . Dátum választás
  • Total KM when Built-In:

  • . . Dátum választás
  • Total KM of Dissassembling couldn't be less than the Total KM of Biult-In. Otherwise Warranty is not allowed.

  • Type here all the parts which were replaced during Built-in

  • Approval
  •  Yes  No


  • The problem
  • Give us enough information about the problem which occoured.
    *

  • Write down why needed to replace the required part!

  • Additionals :
  • Add attachment(s)...


    About attachment(s) :

    • You don't have to attach any file, may it should help later.
    • Maximum filesize is 5 MB.
    • Only JPG, GIF, PNG, PDF filetypes are allowed.