| FSWAZ Application for Parts Warranty | |
| This form is to be filled out by the customer, with assistance from FSWAZ personnel for all part(s) failures. Please answer all questions. Use N/A if not applicable. Return completed copy of form with defective part. |
| Customer Name: | Required |
| Address: | |
| City: | |
| State: | |
| Zip Code: | |
| Phone Number: | Required |
| Truck Make and Model: | |
| Truck Serial Number (17 digits): | Required |
| Engine Model: | |
| Engine Serial #: | |
| Name of Part(s): | |
| Part Number: | Required |
| Complaint: (120 characters max) | A summary of complaint is required. Exceeded maximum number of characters. |
| Cause: (120 characters max) | A summary of cause is required. Exceeded maximum number of characters. |
| Correction: (120 characters max) | A summary of correction is required. Exceeded maximum number of characters. |
| Mileage of the Unit Originally Installed: | Required |
| Mileage of the Unit when Part(s) replaced: | Required |
| Invoice # of Original Invoice: | Required |
| Date of Original Invoice: | RequiredInvalid Date |
| Invoice # of Second Invoice: | Required |
| Date of Second Invoice: | RequiredInvalid Date |
| Invoice # of Credit Invoice: | |
| Date of Credit Invoice: | Invalid Date |
| Invoice # of (&WPC) Invoice: | |
| Date of (&WPC) Invoice: | Invalid Date |
NOTE : FREIGHTLINER OF ARIZONA IMPLIES NO WARRANTY. IF CLAIM IS DENIED OR CHARGED BACK BY THE O.E.M. OR THE MFG. VENDOR, THE NET 30 CUSTOMERS WILL BE INVOICED ON THEIR OPEN PARTS ACCOUNT. IF IT IS NECESSARY TO TEAR DOWN PART(S) FOR WARRANTY INSPECTION AND IS DETERMINED TO BE NON-WARRANTABLE BY THE VENDOR CUSTOMER IS LIABLE FOR EXPENSE OF THE TEAR DOWN.
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