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/Walker Monroe Dynomax Installer Retailler Warranty Claim Form.pdf
Installer Retailer Warranty Claim FORM A CONSUMER INFORMATION Consumer Name Address City State Province Zip Postal Code The minimum requirements for a consumer to be eligible for Warranty coverage are nTo be the Original purchaser of the qualifying Tenneco Automotive products nTo present the Bill of Sale for the original purchase of the qualifying Tenneco Automotive products which clearly has part number and other customer information a copy will need to be submitted with warranty claim documentation Note Consumer retains original Bill of Sale as documentation for future warranty needs Consumer Signature Print Name Replacement Date MM DD YY Consumer Telephone INSTALLER RETAILER providing warranty replacement This section must be completed to ensure credit Telephone Retailer Name Telephone Installer Name Address City State Province Zip Postal Code INSTRUCTIONS TO INSTALLER RETAILER You will need to complete all sections of this form to ensure credit Attach the following to the Tenneco Automotive Warranty Claim form TA 10023 0405 and return to the supplier for credit Copy of Bill of Sale for original purchase Part numbered box end flaps Parts removed must be returned to supplier Revised Effective 05 01 05 Tenneco Automotive Warranty Center 2005 Tenneco Automotive Printed in U S A TA 10023 0405 06 Other Both 07 Binder RC 08 No Gas RC 09 Fit Both 10 Appearance Both 12 Air Leak Both 13 Ride RC 14 Customer Satisfaction Both 15 Broken Unit Both 16 Loose Internals EC Baffles 17 Roving Blow Out EC 01 Leaking Fluid RC 02 Broken Unit Both 03 Noisy Both 04 Worn Out Both 05 Changeover Both PRODUCT DEFECT KEY C REPLACEMENT PART NUMBER If Other Both 06 is used as defect code please provide detailed description B VEHICLE INFORMATION Vehicle Original Part Number Replacement Part Number Quantity Product Defect Code Product Date Code Original Installation Mileage Original Date of Purchase Present Mileage YEAR Example 1993 MAKE Example Chevrolet MODEL Example Lumina
