Warranty Claim

Customer Information

Your Name *

Company Name *

Phone Number *

Email *

Address *

Address 2

City *

Country *

Province/State *

Postal Code *

Vehicle Information

Type *

Product Date Code

Make *

Install Date *

Model *

Install Miles *

Year *

Failure Date *

Vehicle Identification Number (VIN) *

Failure Miles/Kms *

Engine Model *

Date of Claim *

Engine Serial Number

Powertrain Expiry Date

Hours of Use

Hours of Use Type MeterEstimated

Claim Number

Reference Number

Problem Description

Check the item(s) that most closely describe the reported problem *

Will Not StartHard StartingLow PowerExcessive Black SmokeEngine SurgeHigh IdleLow IdleGovernor Will Not Respond to Load ChangeWill Not Low Idle -- StallsEngine Under-Runs Low Idle SpeedHigh Low Idle RPMEngine Over-Runs High Idle SpeedOverspeedExcessive Fuel ConsumptionNoisy PumpOther SpeedsEngine RoughImproper supply Pump PressureFuel LeakLube Oil DilutionAccessories : Broken / InoperativeOther

Description of Problem and Action Taken. If parts were installed, identify below. *

Comments

Diagnostic Tool

Diagnostic Trouble Codes

Warrantied Parts Information

Is the warrantied part a trim coded injector? *YesNo

Original Vara Turbo Technics Invoice Number *

Part Numbers and Quantities *

Has the Part Been Replaced? *YesNo

Attach Supporting Documentation