Your Account Number Date of Claim Warranty Card Number by daylah


									   Your Account Number:                                                                  Warranty Card Number:
                                                                                         Only Needed if sold in 2005 or newer
   Date of Claim:
                                                                                         Warranty Claim Number:
                                                                                         Supplied By Kverneland

Standard Warranty Claim:                         Modification Claim:                         Modification Kit:              Spare part Claim:
Machine Information :
 Model:                                                Serial Number:                                         Delivery Date:

 Failure Date:                                         Repair Date:                                           Tractor Used:

 No of Bales:                                          Ha/Hrs Worked:                                         Engine HP:

 Full Detail’s of Failure:

                                                                                                            (Please add pictures where applicable)

 Full Detail’s of Repair:

   QTY       Part Number Description                                                                Price        Invoice #          Damage Code
   Primary Part Failure

   Other Parts Used                   Labor               Hrs X$                   Per Hr =

   Claim Filled out by:                                                         Signature:

 If you need more room please attach a second blank sheet with info                Return Completed form to:
 needed for claim on it. As well as all supporting Invoices. A list of damage      Rowterra Distributors 26899 Old Yale Rd. Aldergrove BC Canada
 codes has been attached for completion of form.                                   V4W3E4 Phone 604-856-4010 Fax 604-856-4180

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