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Application must be submitted to your Distributor within 30 days of repair

Warranty Claim Form

Dealer Information (Contractor/HVAC Company)


Customer Information (End-user/Equipment Owner/Homeowner)

Homeowner/Owner Name
Homeowner/Owner Address

Warranty Type

Warranty Type

Application Type

Application Type

Unit Information

Parts Information

1st Part Information


Causal Part
This is the part that caused the initial failure (only one part applies)
(Not Vendor #)


(Not Vendor #)

Quality Information

(Labor Allowance is based on the selection of a Labor Repair Type)
Select the main component that failed and the failure mode.
Please provide a detailed description of how the part failed and what diagnostic steps were used to determine the failure mode.
Click or drag files to this area to upload. You can upload up to 5 files.
Clear Signature
Please use your mouse to sign.
A copy of this form will be emailed to you for your records.
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