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Get Lippert Warranty Claim Form

Claim MUST be remitted by mail fax or e-mail to dealerclaims lci1. com to be processed. Claims remitted with returned parts will not be accepted. Unit Owner MUST Sign the LCI WARRANTY CLAIM FORM. LIPPERT WARRANTY CLAIM FORM E-mail dealerclaims lci1. com Clear Form Fax 574 534-7161 Dealer Information Dealer Name Contact Phone Fax Cell E-mail Address City State FID Zip RMA Retail Customer Information Retail Name Contact Zip Rev 11. 13. 2014 Page 1 Lippert Warranty Claim Form Coach Information Complete VIN Model OEM DOM Make DOP Claim Information Parts Cost Labor Time Hrs Parts Markup Labor Rate US Freight Total Total Time x Rate Date of Repair Total Parts Labor Freight PARTS INVOICE MUST ACCOMPANY WARRANTY CLAIM Claim Description LCI Warranty Claim Form must be filled out COMPLETELY and remitted with complete REPAIR ORDER attached Leaving ANY information blank delays the claim process and will result in NON COMPENSATION for any and all parts labor and freight. RO must accompany this form* A W-9 form must be on file with LCI for the Warranty Dept. to process a claim* Please fill out attached W-9. RMA Number must be provided in the DEALER INFORMATION Section of this form* Claim will be delayed without RMA. Signature Date Please sign Warranty Claim Form above or provide a signed copy of the work order attached to this form* Page 2. RO must accompany this form* A W-9 form must be on file with LCI for the Warranty Dept. to process a claim* Please fill out attached W-9. RMA Number must be provided in the DEALER INFORMATION Section of this form* Claim will be delayed without RMA. RMA Number must be provided in the DEALER INFORMATION Section of this form* Claim will be delayed without RMA. Signature Date Please sign Warranty Claim Form above or provide a signed copy of the work order attached to this form* Page 2. RO must accompany this form* A W-9 form must be on file with LCI for the Warranty Dept. to process a claim* Please fill out attached W-9. RMA Number must be provided in the DEALER INFORMATION Section of this form* Claim will be delayed without RMA. Signature Date Please sign Warranty Claim Form above or provide a signed copy of the work order attached to this form* Page 2.

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