Warranty Claim Form
Email
example@example.com
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SUPPLIER TICKET #
SUPPLIER APPROVAL #
ECLIPSE REPAIR ORDER #
Back
Next
VEHICLE DETAILS
Chassis Number
Located on draw bar or proof of purchase document.
RV / Caravan Make / Brand
Please Select
Ask Innovation
Aura Caravans
Aussie 5 Star
Avida
Eden Caravans
GoodLife
Lagoon
Newgen Caravans
Nextgen Caravans
Option RV
Orca Campers
Regent
Snowy River
Trackvan
Dometic
Thetford
Swift
Leisure Tec
Coast to Coast
Milenco
Truma
OTHER
NWC
Retail
RV/Caravan Model
Purchase Date
 -
Day
 -
Month
Year
Date
Receipt/ Proof of Purchase
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Do you want Green RV to do your repairs?
Yes
No
Unsure
Back
Next
FAULT #1 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #1 - Part Description / Part Identification
*
Example: Dometic Airconditoner
FAULT #1 - Part Dimensions
*
Example: Width 500mm x Depth 200mm
FAULT #1 - Fault Description
*
Example: Won't turn on, No lights or Air blowing. Be as descriptive as possible.
FAULT #1 - Photo or Video Showing Fault !! REQUIRED !!
*
WARNING: Claims without visual evidence will be VOIDED
Drag and drop files here
Choose a file
ALWAYS Upload photo of serial number when possible. TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo.
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #2 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #2 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #2 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #2 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #2 - Photo or Video Clearly Showing Fault !! REQUIRED !!
WARNING: Claims without visual evidence will be VOIDED
Drag and drop files here
Choose a file
ALWAYS Upload photo of serial number when possible. TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #3 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #3 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #3 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #3 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #3 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #4 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #4 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #4 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #4 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #4 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #5 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #5 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #5 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #5 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #5 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #6 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #6 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #6 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #6 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #6 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #7 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #7 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #7 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #7 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #7 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #8 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #8 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #8 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #8 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #8 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #9 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #9 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #9 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #9 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #9 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #10 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #10 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #10 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #10 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #10 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #11 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #11 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #11 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #11 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #11 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #12 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #12 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #12 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #12 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #12 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #13 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #13 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #13 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #13 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #13 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #14 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #14 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #14 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #14 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #14 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #15 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #15 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #15 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #15 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #15 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #16 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #16 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #16 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #16 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #16 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #17 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #17 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #17 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #17 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #17 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #18 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #18 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #18 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #18 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #18 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #19 - DESCRIPTION & DETAILS
One fault per page! Click 'Next' to add more
FAULT #19 - Part Description / Part Identification
Example: Dometic Airconditoner
FAULT #19 - Part Dimensions
Example: Width 500mm x Depth 200mm
FAULT #19 - Fault Description
Example: Won't turn on, No lights or Air blowing.
FAULT #19 - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
Additional faults to claim? click "NEXT"
Back
FINISH & SUBMIT
NEXT
FAULT #20 or MORE - DESCRIPTION & DETAILS
More than 20 faults? You can enter multiple faults on this page if needed.
FAULT #20 or MORE - Part Description / Part Identification
FAULT #20 - FAULT #21 - FAULT #22 -
FAULT #20 or MORE - Part Dimensions
FAULT #20 - FAULT #21 - FAULT #22 -
FAULT #20 or MORE - Fault Description
FAULT #20 - FAULT #21 - FAULT #22 -
Example: Won't turn on, No lights or Air blowing.
FAULT #20 or MORE - Photo or Video Clearly Showing Fault
Browse Files
Drag and drop files here
Choose a file
TIP: Send PHOTOS for clearly visible faults; Only use VIDEO if unable to demonstrate fault with photo
Cancel
of
STATUS
FINISH & SUBMIT
Should be Empty: