COYOTE WARRANTY CLAIM SUBMISSION FORM

DATE FILED

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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