Please provide the following contact information: Name Title Organization Street Address Address (cont.) City State/Province Zip/Postal Code Country Work Phone FAX E-mail Service Manager Service Manager Email Parts Manager: Parts Manager Email Warranty Claim Administrator Warranty Administrator Email Warranty Claim Filing Information Authorization Number Required Parts Discount (If yes, please give %) Parts Handling Warranty filing deadline Online filing (If yes, please give web address) Parts return Prior Approval Do you have authorized servicers? If no, can any servicer complete warranty? Additional Information (Please list any other information that will assist in filing a warranty claim properly.)