WARRANTY CLAIM FORM

Jackson Grills is not liable for wrong warranty parts shipped if item code is not provided in the warranty claim form. Homeowner proof of purchase and photos of each faulty part are required.

Company(Required)

Requested By(Required)

Email(Required)

Customer Name(Required)

Full Name

Model # (Use actual item code)(Required)

Serial # (complete 3-20 digits)(Required)

Customer Product Purchase Date(Required)

Date Failure Reported to Dealer(Required)

Detailed Description of Problem(Required)

Detailed Description of Repair(Required)

Parts Used / Needed (Use actual item code and quantity; if item code unknown please refer to manufacturer website, manual, or contact Concorde's sales department). No item code will delay processing

Parts number(Required)

Quantity(Required)

Parts number(Required)

Quantity(Required)

Parts number(Required)

Quantity(Required)

Parts number(Required)

Quantity(Required)

Warranty Parts(Required)

Need to order part (Will be shipped - Fill in PO# below - DO NOT chose this option if you have already ordered a replacement part, if so check the second option).

Part came from Dealer Stock (Credit requested only - This DOES NOT order parts).

Provide a PO # if Part Needs to be Shipped or the invoice number of parts used from stock(Required)

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Upload images for this warranty claim. Press "Upload a File" below to upload images.

Max. file size: 2 GB.

Note: A photo of damaged/faulty parts must be included with claim. Proof of purchased is required for all warranty claims.

Upload images for this warranty claim. Press "Select files" below or drag and drop to upload images. Max. 4 images.

Drop files here or

Max. file size: 512 MB.

Note: A photo of damaged/faulty parts must be included with claim. Proof of purchased is required for all warranty claims.

WARRANTY CLAIM FORM

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