Warranty

Warranty Claim Form

Please include as much relevant information as possible to ensure timely processing of any warranty claim.

Business Name:

Contact Name:

Phone Number:

Address:

Invoice/Claim Number:

Liftgate Model Number:

Serial Number:

Email:

Date Submitted:

Liftgate Problem:

Repair Procedure:

Part Number

Quantity

Description

Claimed Cost:

Total

Flat Rate Labor Total

Misc. Cost Total

Claim Total

No Documents

All files must be uploaded or cleared before completion.

Supplier Labor:

Supplier Parts:

ALG Labor:

ALG Parts:

Pay:

Invoice Number:

Price:

Status:

Payment Type:

Check Number/Credit Memo:

Payment Date:

Notes:

Mark Paid:

Mark Complete: