WARRANTY CLAIM FORM

Trailer Information

Date of Purchase(Required)

Date of Failure(Required)

Trailer VIN#(Required)

Engine Serial number (if engine related failure)

Who is submitting the claim(Required)

Dealer

Customer

Dealer Information

Dealer Name

City

State

Who to Contact

Phone Number

Email

A copy of your claim will be emailed to you after submission

Customer Information

Company Name

City

State

Who to Contact

Phone Number

Email

A copy of your claim will be emailed to you after submission

Claim Description

Claim Details (be as specific as possible)(Required)

Images of Claim (if applicable)

Max. file size: 256 MB.