Spheros Warranty Claim Form
Spheros North America, Inc.
9
www.spheros.us
WARRANTY CLAIM FORM
Please return defective part/s identified with an RMA no. to
Spheros North America, Inc
.
Warranty is accepted according to the Warranty Policy Terms and Condition. Fill up shaded field.
Incomplete form will not be processed. Credit memo will be issued once warranty is accepted.
Send completed form through e-mail:
Dakota.Elswick
@Spheros.us
or fax at
(
574
)
326
-
3015
.
Note: The product serial no. will be the claim no. for this warranty claim.
For hatch claims, Spheros North America, Inc. will provide the claim no.
Product Category:
☐
Heater
☐
A/C
☐
Hatch
☐
Others,
Please specify
__________________
Please cross box provided
Product Serial No. / Unit Model
File Date
P.O Reference:
RMA No.
Vehicle Identification No. (VIN):
Make/Model:
Model Year:
Date of Registration/Purchase:
Dealer Name:
Address:
Contact Details:
Contact Person:
Phone: (
)
Customer Name
Address:
Contact Details:
Contact Person:
Phone: (
)
Defect/Complaint Description : (Attach error report from Thermo test tool is claim is under heater category)
Product condition:
☐
New/Zero-Mile
☐
Used; Mileage_____________ (Only for heater. Readable via thermo test tool)
This section shall be filled up by Spheros or accredited service provider
Evaluation Result: ( State briefly)
Service Technician:
Disposition
☐
Accepted.
(Fill up repair detail section)
☐
Refused
(Inform customer on the rejection by sending the warranty claim form if necessary. Fill up repair detail section if
customer request to repair of unit )
Customer disposition if warranty is void
☐
Return
☐
Repair/Invoiced
☐
Scrap on Site
Authorized by:
Name below signature
Date
____________
Repair Details
P.O no. ( P.O support customer authorization to repair the unit.)
Quantity
Part No.
Description
Price
Sub total
Labor rate/hr (
If applicable
)
Repair Time (hr) (
As per Spheros Labor Time Guide
)
Labor
To be filled up by Spheros North America, Inc.
Handling
Warranty Cost Disposition:
☐
Approved
☐
Disapproved , Adjusted Amount ($)
__________________
Approved by: ____________________
Name below signature
TOTAL
Chargeback no.
Close Date:
Summary of Contents for DBW 230
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