Warranty Claim Form

Product Line

Please choose the product line for which you are submitting a warranty. If you are submitting a warranty for RV Towing Products or Supplemental Braking System Products, please call Demco at 1-800-543-3626.

Harvest EquipmentApplication EquipmentSemi-Trailers

Filled out by

Distributor or Dealer Name

Dealer Phone Number

Address

City

State

Zip Code

Customer Name

Address

City

State

Zip

Phone Number

Vin or Serial Number

Base Unit or Attachment That Failed

Make & Model

Date of Purchase

Date of Failure

Acres/Hrs Operated

Part Number of Affected Item

General Description of Warranty Claim

Complaint

Date of Work Performed

Labor Hours

Invoice, Work Order, or Photo Upload