Material Partially Or Not Installed Claim Form

Material Partially or Not Installed Claim Form

Please fill out the material partially or not installed claim form below.

"*" indicates required fields

T&A Rep Email*

Claim Submitter's Email*

Dealer Information

T&A Representative

Has the dealer been on-site to review this claim?

Yes

Not Sure

Dealer Name

Dealer Contact Name

Dealer Phone Number

Dealer Contact Email

Dealer Street Address

City

State

Zip Code

Consumer Information

Consumer/Job Site Information

Consumer/Job Site Name

Consumer/Job Site Phone

Consumer/Job Site Address

City

State

Zip Code

Product Information

Product Name

Product SKU

Reference Number

Invoice Number

Inspection Required

Yes

Claim Information

Date Reported

Submitted By

Describe the Issue

Please Submit Photos or Other Evidence that Support your Claim.

Drop files here or

Max. file size: 50 MB.

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Products

Installation Supplies

Resources