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HVAC Warranty Claims

HVAC Warranty
  2. SERVICER INFO:
  3. Servicer(*)
  4. Street(*)
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  5. City(*)
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  6. Province(*)
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  7. Postal Code(*)
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  8. Phone(*)
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  9. Your Email(*)
    Please let us know your email address.
  10. Equipment Manufactured By(*)
    Invalid Input
  11. CUSTOMER INFO:
  12. Customer Name(*)
  13. Street(*)
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  14. City(*)
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  15. Province(*)
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  16. Postal Code(*)
    Invalid Input
  17. Phone(*)
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  18. WARRANTY STATUS:
  19. Warranty Status(*)



    Please check one
  20. If Authorization Number or Program Number are checked above, please provide the corresponding number in the appropriate field below.
  21. Authorization Number
    Invalid Input
  22. Program Number
    Invalid Input
  23. GENERAL INFO:
  24. Model Number(*)
    Invalid Input
  25. Serial Number(*)
    Invalid Input
  26. Install Date(*)
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  27. Failed Date(*)
    Invalid Input
  28. Repair Date(*)
    Invalid Input
  29. Customer Complaint(*)
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  30. Corrective Action(*)
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  31. PARTS & DESCRIPTION INFO:
  32. Part Number
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  33. Description
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  34. Failure Code
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  35. Quantity
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  36. --------------------------------------------------------
  37. Part Number
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  38. Description
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  39. Failure Code
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  40. Quantity
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  41. --------------------------------------------------------
  42. Part Number
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  43. Description
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  44. Failure Code
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  45. Quantity
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  46. --------------------------------------------------------
  47. Part Number
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  48. Description
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  49. Failure Code
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  50. Quantity
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  51. --------------------------------------------------------
  52. Part Number
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  53. Description
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  54. Failure Code
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  55. Quantity
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  56. --------------------------------------------------------
  57. Part Number
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  58. Description
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  59. Failure Code
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  60. Quantity
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  61. --------------------------------------------------------
  62. I Certify That This Is A True And Complete Statement Of Work Carried Out(*)


    Invalid Input
  63. --------------------------------------------------------
  64. Please type your name in the box below which will be considered an electronic signature in the place of your handwritten signature.
  65. Electronic Signature(*)
    Invalid Input
  66. HVAC Warrnty Claim Must:
    - Be received by Mit Airconditioning Inc. within 30 days of repair date
    - All Parts requiring return must be accompanied by this form
    - Only one base serial unit number may be used on one claim form
    - Cost of parts only - labour and transport charges are the responsibilty of the contractor / servicer

    ONLY ACCURATE AND COMPLETE CLAIMS WILL BE PROCESSED. ALL OTHER WILL BE REJECTED.

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