Warranty Claim Form
DieselAutoPower.com
DAP Sales Order Number
*
Part Number
*
Part Type
*
Please Select
Injectors
Injection Pump
Turbo
Turbo Actuator
Other-Fill out below
Other (Part Type)
Customer Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Customer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vehicle Information
*
Year
Make
Model
Vehicle Identification Number (VIN)
*
Original Issue Prior to Replacing:
*
Describe In Detail the Diagnostic Steps Performed:
*
Include when symptoms occur
Upload Images
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Diagnostic Codes
*
Diagnostic Tool Used
*
Installation Date
*
-
Month
-
Day
Year
Date
Failure Date
*
-
Month
-
Day
Year
Date
DAP Warranty Policy
Customer Signature
*
Date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit
Should be Empty: