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KATO IMER Warranty Claim Form
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* Indicates required question
Customer name:
*
Your answer
Customer email:
*
Your answer
Location (city and state):
*
Your answer
Invoice number
Your answer
Machine model:
*
Your answer
Serial number:
*
Your answer
Attachment serial number (if applicable):
Your answer
Machine hours:
*
Your answer
Purchase/delivery date:
*
MM
/
DD
/
YYYY
Failure date:
*
MM
/
DD
/
YYYY
Repair date:
*
MM
/
DD
/
YYYY
Description of failure and resolution:
*
Your answer
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