MOUNTAIN WEST IN/OUT WARRANTY REPAIR FORM

 RA#:
A Sales receipt must be included for all warranty repairs, credits and exchanges.     
Form information must be complete.		 Date:

Please fill out this form on line, print it and fax it to the Mountain West office that serves you.

Salt Lake City: (801) 467-3006

Denver: (303) 371-7787

Phoenix: (602) 437-1327

Or email to repair@mountainwestdistributors.com

CUSTOMER INFORMATION:
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE#:

DEALER INFORMATION:
DEALER:
CONTACT NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE#:

UNIT INFORMATION
MAKE:  MODEL:  
SERIAL #:

PROBLEM WITH UNIT:
SERVICE REQUESTED

WARRANTY REPAIR

 CREDIT EXCHANGE
STORE STOCK WARRANTY NON-WARRANTY WITH ESTIMATE FEE

**WARRANTY DOES NOT COVER SHIPPING AND HANDLING TO THE REPAIR LOCATION. THIS IS THE CUSTOMER/DEALER  RESPONSIBILITY!**

NOTES / SPECIAL INSTRUCTIONS / DAMAGE / ACCESSORIES:

Please fax this request to the office that serves you.

Salt Lake City: (801) 467-3006

Denver: (303) 371-7787

Phoenix: (602) 437-1327

Or email to repair@mountainwestdistributors.com