WARRANTY CLAIM FORM
Failed or defective parts
Teknorot Customer Details
Please complete the details of the company who purchased the item from Teknorot
Sender's Name
Business Name
*
Teknorot Account Code
*
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000-000-000.
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Purchase & Installation Details
Teknorot Invoice Number
*
Teknorot Part Number
*
Customer Name
*
First Name
Last Name
Registration Number
*
State
*
Please Select
New South Wales
Victoria
Queensland
South Australia
Western Australia
Tasmania
Northern Territory
Australian Capital Territory
Vehicle Make
Vehicle Model
Engine Code
Year
VIN
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Additional Information
Date Fitted
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Mileage Fitted (KMs)
*
Date of Alleged Failure
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mileage Failed (KMs)
*
Photo of the faulty part
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Photo showing the Teknorot branding on the product
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Details of Claim
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