HVAC Warranty ~ Rheem-Ruud-Mainline~~Customer Entry
I have verified the parts included in this claim, that they are under warranty.
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Yes
No
Email to Receive Claim
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example@example.com
Date
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-
Month
-
Day
Year
Date Picker Icon
Location Name
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Location #
*
Location City
*
Contractor/Company {Name of account in Hajoca System}
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Hajoca Account # for Customer/Company
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Reference #/PO {For Customer Refernce Only}
Warranty Brand
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Already gotten the replacement and now filing?
Please Select
No
Yes
Where did you Purchase the Replacement Part
Invoice Number of Replacement Part*
*
Please put the invoice number where you purchased it from
Is the system Registered?
Yes
No
Not registered equipment ~ Install & Fail date
Homeowner Full Name - First & Last
*
Homeowner Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Equipment Model
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Equipment Serial #
*
Failed Replacement
Choose Failed Model/Part
*
Please Select
Failed Compressor
Failed Coil
Failed Inverter Drive Motor
failed Equipment (System)
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field
Failed Serial #
*
Failed Model/Part #
*
Reason for failure
*
Replacement Model/Part
*
Please Select
Failed Compressor
Failed Coil
Failed invertor drive motor
Failed equipment {system}
Other
If Chose Other - Specify what
*
If you chose other what is it? Type in the field. N/A if not applicable.
Replaced Model/Part #
*
Replaced Serial #
*
Replacement part brand if not Rheem
Request Labor Cost if Applicable?
Please Select
Failed Replacement - 2 (Do you have more parts for the same equipment?)
Choose Failed Model/Part
Please Select
Failed Compressor
Failed Coil
Failed Inverter Drive Motor
failed Equipment (System)
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field
Failed Serial #
Failed Model/Part #
Reason for failure
Replacement Model/Part
Please Select
Failed Compressor
Failed Coil
Failed invertor drive motor
Failed equipment {system}
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field. N/A if not applicable.
Replaced Model/Part #
Replaced Serial #
Replacement part brand if not Rheem
Request Labor Cost if Applicable?
Please Select
Failed Replacement - 3 (Do you have more parts for the same equipment?)
Choose Failed Model/Part
Please Select
Failed Compressor
Failed Coil
Failed Inverter Drive Motor
failed Equipment (System)
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field
Failed Serial #
Failed Model/Part #
Reason for failure
Replacement Model/Part
Please Select
Failed Compressor
Failed Coil
Failed invertor drive motor
Failed equipment {system}
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field. N/A if not applicable.
Replaced Model/Part #
Replaced Serial #
Replacement part brand if not Rheem
Request Labor Cost if Applicable?
Please Select
Failed Replacement - 4 (Do you have more parts for the same equipment?)
Choose Failed Model/Part
Please Select
Failed Compressor
Failed Coil
Failed Inverter Drive Motor
failed Equipment (System)
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field
Failed Serial #
Failed Model/Part #
Reason for failure
Replacement Model/Part
Please Select
Failed Compressor
Failed Coil
Failed invertor drive motor
Failed equipment {system}
Other
If Chose Other - Specify what
If you chose other what is it? Type in the field. N/A if not applicable.
Replaced Model/Part #
Replaced Serial #
Replacement part brand if not Rheem
Request Labor Cost if Applicable?
Please Select
Finalization of Claim - Click to Complete
At this time uploads are not required, but you can load any relevant information to keep all the details in the claim for your records. Anything to upload?
*
Please Select
No
Yes, proceed to upload
Files for Backup to the Claim
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I agree to that all the information that is entered is valid and accurate
*
Please Select
Agree
I agree to hold on to the items in this submission until notified by the DSC Warranty Team on how to proceed with the items in the submission.
*
Please Select
Agree
I agree to honor the DSC warranty team's requests to take the requested items to a local location. I must do so within 10 days, or the submission will be deleted, and the claim will not be processed. If i have received credit already this also acknowledges the said credit will be reversed.
*
Please Select
Agree
Notes:
Submit
DSC Shared Services Email
example@example.com
Should be Empty: