Yanmar Industrial Warranty Claim Form

All dealers responsible for retaining failed warranty parts for no less than 120 days after warranty has been paid. Please keep parts in a cool, dry storage area. These parts should be kept out of sight of the retail public and made available to MEC or Yanmar upon request.

Dealer Information

* Dealer Account Number

Dealer Claim / Reference Number

* Dealer or OEM Name

* Street Address

Address Line 2

* City

* State/Province/Region

* Zip/Postal Code

* Phone Number

* Country

* Email Address

* Confirm Email Address

Customer Information

* Name

* Street Address

Address Line 2

* City

* State/Province/Region

* Zip/Postal Code

* Phone Number

* Country

Claim Data

* Engine Model

* Serial Number

* Machine Model

* Serial Number

* Hours of Use

Mech. Name

Repair Location

* Spec Location

* Rental Use?

* Delivery Date

* Failure Date

* Repair Date

Explanation of Failure

* Complaint

* Cause

* Correction

Work Hour(s) Break Down

	Time in Hours
Diagnosis
Repair
Break In
Cleaning
Any Additional Time Required
Total Repair Time

Reason for Additional Time

* Failed Component/Part Number

Part(s) Used

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Warranty Labor

Working Hours

Rate

Total

Travel Hours

Rate

Total

Number of Units

miles

Rate

Total

Others

Explanation

Total Parts

Total Labor

Dealer Notes

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* Indicates Response Required

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