ICP Warranty Form
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WARRANTY CLAIM FORM #751
 
Distributor/Dealer *
 
Account # *
 
Distributor Debit # *
Location
Homeowner's Name
Address
City
Stae/Zip
Phone #
 
Unit Model Number *
 
Unit Serial Number *
 
Unit/Fast Part Start-Up Date *
 
Unit/Fast Part Date Failed *
 
Servicing Dealer *
 
City: *
 
State/Province Postal Code *
 
Phone # (with area code) *
 
Claim Date *
Distributer Claim #
WARRANTY STATUS
MAINLINE EQUIPMENT
Notes
1 ) Part Number (please include manufacturer's suffix)
Failed
Replacement
Quantity
Description
Scrap
Compressor/Component Model Number
Compressor/Component Part Date Code/ Serial Number
2 ) Part Number
Failed
Replacement
Quantity
Description
Scrap
Compressor/Component Model Number
Compressor/Component Part Date Code/Serial Number
3 ) Part Number
Failed.
Replacement.
Quantity.
Description.
Scrap.
Compressor/ Component Model Number
Compressor/ Component Part Date Code/ Serial Number
DEFECT CODES
Refrigerant System
Restrition
Other
Electrical



No Hassle 'Only'


Mechanical




SPECIFIED FACTORY PROGRAMS ONLY
Warranty Options and Labor Data
Operating Letter/ Service Bulletin #
Moile Home/Policy/Travel
Time Worked
Travel Roundtrip in Miles
If part is to be returned to manufactuer call Warranty at 316-263-8179 ext. 263.
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Phone: 316 263-8179 or 800 835-1010, Fax: 316 263-2040 or 800 835-1150
224 Indiana,    Wichita,  Ks   67214
8:00 AM to 5:30 PM M-F,  8:00-Noon on Saturday,  Closed on Sundays and Holidays.
Tempstar Distributor for Kansas

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