COYOTE WARRANTY CLAIM SUBMISSION FORM

DATE FILED

mm/dd/yyyy

VIN/HULL ID

TRAILER OWNER NAME

TRAILER OWNER ADDRESS

TRAILER OWNER PHONE NUMBER

TRAILER OWNER EMAIL

DEALERSHIP WHERE WORK IS TO BE DONE

DEALERSHIP ADDRESS

DEALERSHIP PHONE NUMBER

DEALERSHIP EMAIL

CLAIM ISSUE

REQUESTED RESOLUTION

PARTS NEEDED

NEED PARTS SENT

USING PARTS ON HAND

REQUESTED PARTS

PARTS COST(IF ACQUIRED FROM OUTSIDE SOURCE)

LABOR COST

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*IF FILING A CLAIM FOR A COYOTE TRAILER, PLEASE PROVIDE A PICTURE OF THE VIN TAG ON TRAILER.

*IF FILING A CLAIM FOR AN AXLE OR ASSOCIATED PART, PLEASE ALSO PROVIDE A PICTURE OF THE AXLE TAG.

*PLEASE PROVIDE ANY PICTURES OF DEFECTIVE PARTS, CLAIMS CANNOT BE PROCESSED WITHOUT THEM.

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