Claim Form
Date
*
/
Month
/
Day
Year
Date
Name
*
First Name
Last Name
Location of Item Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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Maine
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Ohio
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Tennessee
Texas
Utah
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State
Zip Code
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Purchase Date
*
/
Month
/
Day
Year
Date
Did you purchase the Guardsman Extended Warranty?
Please Select
YES
NO
Sales Order #
*
Order Issue:
*
Please Select
Damaged
Missing Item
Wrong Item Delivered
Wide Shot of Item:
*
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Close Up of Issue:
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Photo of Production Tag:
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Other Photos:
*
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Describe the issue
*
If you have any further questions, please contact Becky at customerservice@strobler.com
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