Raptor Series New Warranty Claim Form

Full Name *

Address *

If this product was purchased as a gift and/or shipped to a a different address, please include that shipping address when filing your claim

City, State *

Zip Code *

Country *

Home Phone *

Please enter your home or cell phone. We will need to contact you about your claim

Email *

Preferred Method of Contact *

Email

Phone

Date Purchased *

Month

Day

Year

Part Number(if known)

Store Purchased From

Was your product installed by store or self *

Store Installed

Self Installed

Please Explain Reason for Claim *

If other please give details

Describe the nature of your problem

Nature of Your Warranty Claim *

Repair

Replacement

Return and Refund

Other

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