SUBURBAN MANUFACTURING COMPANY
676 Broadway Street
Dayton, Tennessee 37321
423-775-2131
www.RVComfort.com
WARRANTY SERVICE CLAIM FORM
ALL SHADED AREAS MUST BE FILLED IN WITH THE CORRECT INFORMATION!
SERVICE COMPANY
TELEPHONE NO.
ADDRESS
CITY AND STATE
ZIP CODE
CUSTOMER NAME
TELEPHONE NO.
ADDRESS
CITY AND STATE
ZIP CODE
SERVICE COMPANY
WORK ORDER NUMBER
SUBURBAN MFG. CO.
CLAIM NUMBER
APPLIANCE MODEL NUMBER:
SERIAL NUMBER:
PURCHASE DATE:
VEHICLE MANUFACTURER:
VEHICLE MODEL:
VEHICLE ID NUMBER:
DATE SERVICE REQUESTED:
WARRANTY AUTHORIZATION NUMBER:
DATE SERVICE COMPLETED:
DIAGNOSIS AND SERVICE PERFORMED
COMPLAINT:
SERVICE PERFORMED:
PARTS USED FOR REPAIR
PART NUMBER
DESCRIPTION
INSTRUCTIONS FOR DEFECTIVE PARTS RETURNS:
FLAT RATE TIME:
LABOR AMOUNT:
$
TOTAL:
$
TECHNICIAN SIGNATURE
DATE
CUSTOMER SIGNATURE/COMPANY NAME
IF NOT ORIGINAL APPLIANCE OWNER
DATE
CHECK ONE
□
APPLIANCE WAS INSTALLED BY AN RV MFG (OEM)
□
APPLIANCE PURCHASED FROM AFTERMARKET
All water heaters, module boards, motors, valves, electric elements, and combustion
chambers must be
properly tagged
and returned for factory inspection within 60
days. The labor claim should be returned with these parts.
All other parts may be field scrapped - please mark on the claim form that the part was
“Field Scrapped”. Field scrapped parts should be held until the claim is approved by
the factory.
DO NOT SUBMIT INVOICE UNTIL SERVICE IS COMPLETE.
Please retain a copy of this form.
Summary of Contents for SW10D
Page 1: ...Suburban Water Heater Service Training Manual...
Page 39: ...39 SW6DEL SW10DEL SW12DEL SW16DEL...
Page 40: ...40 NOTES...
Page 41: ...NOTES 41...
Page 42: ...NOTES 42...