Warranty Claims Form

1. Contact Name
2. Email

1. Phone
2. Position Vehicle OperatorMaintenance DeptManagementEquipment DealerOther

1. Dealership Name
2. Address

1. City
2. State
3. Zip

1. Was the product purchased through this dealership? YesNo

1. Company
2. Address

1. City
2. State
3. Zip

1. Model
2. Serial
3. Manufacturing Date

1. Current Location
2. Location Contact #

1. OwnRentLease
2. Vehicle Error Code (if applicable) —Please choose an option—NoCode 23Code 31Code 34Code 41Code F17001Code F18002Code F18003Code F22001Code F22003Code F22004Code F37003Code F44001Code F53003Code F53004Code Not Listed

2. Please describe the issue you are experiencing.

Include up to three images or documents (5Mb Max.) on your warranty claim.

By agreeing, you are confirming that you have reviewed the warranty claims process and are providing accurate information on the status and ownership of the product. Wesley International reserves the right to deny warranty claims not correctly submitted through the claims process or contain egregious errors or falsified information.

1. I AGREE