Warranty Accessory Claim Form - THAWZALL ground thawing and cold weather concreting for winter construction.

SUBMIT ONE CLAIM PER ACCESSORY

Your Company Information ALL FIELDS REQUIRED IN THIS SECTION
Your Company Is: Company Name: Your First Name: Your Last Name: E-Mail Address: Company Street Address: City: State/Province: Zip Phone Number: Fax Number:

Equipment Information ALL FIELDS REQUIRED IN THIS SECTION
Original Purchase Date: Warranty is valid for 1(one) year from date of ORIGINAL purchase. Do not submit a claim for equipment which is more than 1 (one) year old. Original Purchase Invoice Number:

Accessory Claim Information
Accessory Model: Accessory Serial Number:

Describe Problem And Solution THIS SECTION REQUIRED
Affected part(s): List part number(s) and description(s) here Describe failure: Describe the failure here. Be specific when describing how the part(s) failed. Describe how the problem was rectified: Include details such as whether a part was replaced or repaired.

Repair Parts Information Both sections may be used if applicable ONE SECTION REQUIRED
REPAIRS MADE BY YOUR COMPANY Complete this section if your company provided repair service Date Of Repair: Number Of Labor Hours: Labor Rate: Labor hours and rate are subject to limitations determined by T.H.E. Machine Company. *PARTS PURCHASED FROM T.H.E. MACHINE COMPANY* Parts Purchase Date: Parts Purchase Invoice Number: Are You Claiming All Parts Listed On This Invoice? Yes No If you answered "No" - Use this area to list part numbers on invoice NOT to be included in this claim.

OUTSIDE VENDOR INFORMATION Complete this section only if an outside vendor provided parts or service Company Name: Company Street Address: City: State/Province: Zip Phone Number: Date of Repair: Amount Paid for Repairs: Invoice #: Additional information will be required if this section is completed.
Do not return failed parts or send correspondence until you have received a confirmation E-mail with an assigned warranty claim number. When you click "Submit" this form will be sent to our Warranty Dept. Please do not print and fax to our office unless instructed to do so.


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THAWZALL™ heater provides ground thawing and concrete curing for winter construction projects.				THAWZALL, Inc. Glenwood, MN (888)757-3545 E-Mail: thawzallinfo@thawzall.com


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