Signature Warranty

1
Customers Information* This field is required.
Customer/Account Number
Name of Business
2
Contact Information* This field is required.
Contact Email
Contact Phone
3
Date of Purchase
Select Date
Year
Month
Day
4
Vehicle Information
Vehicle Year / Make / Model
Original Installation Date
Mileage at Repair
Sunroof Batch / Serial Number
Sunroof Model
Part # / Description
Vin #
5
Has this vehicle been service before?
Select One
NO
YES
MORE THAN ONCE
Service History
Dealership / Consumers Name
6
Warranty DescriptionPlease describe the purpose of the warranty or parts needed or any other comments.
Huge
Large
Normal
Small
Ok
Ok
7
File Upload* Please be sure to attach a photo of the damage product along with this form.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
8
Submitted By* This field is required.
Submitted By
Date
Title
9
Tracking Code
Should be Empty: