Petersen Industries, Inc. Manufacturer of Lightning Loader Grapple Trucks / Knuckleboom Loaders

Manufacturer of Lightning Loader® Grapple Trucks

Warranty Claim Form

INSTRUCTIONS: ALL information in the first section of this form must be completed before submitting the claim form to Petersen. Warranty Replacement parts will not be shipped unless a completed Warranty Claim Form has been received by Petersen. The part in question is to be returned to Petersen for warranty placement approval. If a replacement part is needed immediately, we will ship the part and invoice you as if it were a parts order and standard payment terms will apply. Once we receive the part in question, and it is found to be defective, we will issue a credit against the original invoice. PETERSEN WILL NOT REIMBURSE WARRANTY WORK PERFORMED WITHOUT PRIOR WRITTEN AUTHORIZATION, OR ANY AMOUNT IN EXCESS OF THE AMOUNT AUTHORIZED.

Equipment Owner:
Email Address:
Today's Date:
Customer Name (If different than owner):
Customer Contact:
Loader Model-Serial #: Example: TL3-0199-1234
Telephone Number:
Fax Number:
Ship to Address:
City, State, Zip:
Describe the nature of the problem:
Warranty Work proposed:
Estimated Labor(in hours):	Submitted By:


Claim#:
Invoice#:
Amount Authorized :
Authorized by:
Date :
Comments :
: