Warranty Claim Forms
For
Products Manufactured by Allmand Bros. Inc.
Holdrege, Nebraska
DATE: / / CUSTOMER CLAIM NO
CUSTOMER
INFORMATION
DEALER/REP INFORMATION___________
Name:_____________________
Name: ________________________
Address: ___________________
Address: _____________________
City: ___________St: ___Zip:______City:
__________St: ____ Zip:________
Phone: __ ______Fax: _____
Phone: ______________Fax:_________
PRODUCT NAME: ________MODEL #: _____________SERIAL #:
______________ HOURS: _____
DATE
PURCHASED: / / DATE PUT IN SERVICE: / / _DATE OF FAILURE:__
/ /
LABOR
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HOURS |
RATE |
DESCRIPTION |
COST $ |
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PARTS
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QTY |
PART NUMBER |
DESCRIPTION |
COST |
ALLMAND INV.# |
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ALL
returnable parts MUST be received and have an RGA number before processing. TOTAL:$__________
RGA#______________
Please
return parts within 30 days for prompt processing of warranty claim.
Total labor cost of repair
or replacement of parts only. ____________LABOR/__________
Total cost of part, or
parts, used in repairing unit. _______________PARTS/
Total amount claimed, parts
and labor combined. _______________TOTAL/ ____
FILED BY: _________TITLE: ___ABI
CONTACT:_______________
______________FOR OFFICE USE ONLY __
DATE RECEIVED: / / DATE PROCESSED
/ /
CREDIT INVOICE
#
RETURN TO: ALLMAND BROS., INC
TOLL FREE: 800-562-1373
WEST HWY 23 PHONE:
308-995-4495
WEST 4TH
AVE FAX:
308-995-5887
HOLDREGE, NE 68949 US
1998-05-07
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