Details of Repair, if any____________________________________________________________________________
Note:
Please contact nearest respective authorised battery dealer for details immediately after purchase of
vehicle.
Name of Dealer & Code :__________________________________________________________________
__________________________________________________________________________________________
Date of claim :________________________________________________Battery Type :_______________
Serial No. :__________________________________________________Date of Fitment :______________
TO BE FILLED IN BY BATTERY DEALERS / DISTRIBUTORS
IN CASE OF CLAIM
# Claim Accepted
## Claim Rejected
Failure Mode (Please tick as applicable)
• Loose connection
• Overcharge / Undercharge
• Internal Short
• Reverse Charge
• Plate Shedding
• High Specific Gravity Electrolyte
• Intercell Connection
• Electrolyte Contamination
• Does not Hold Charge
• Electrolyte Level not Maintained
• Wrong Assembly
• Left Lying Idle
• Wrong Application
• Terminal Corroded