Required fields are marked with

1. Warranty performed by

2. Account Number:
3. Name:
4. Address:
5. Suburb:
6. State: NSW QLD VIC WA SA TAS NT ACT
7. Postcode:
8. Phone Number:
9. Email Address:

1. Owner of machine

2. Commercial User: Yes No
3. Name:
4. Address:
5. Suburb:
6. State: NSW QLD VIC WA SA TAS NT ACT
7. Postcode:
8. Phone Number:

2. Petrol or Diesel Claim Petrol Diesel
3. Engine model No
4. Spec No or K-Number
5. Engine Serial Number
6. _{Please note: Petrol engines 10 digits, Diesel engines 7 digits.}
7. _{Please note: Petrol Engine Serial Number can be found on the black}
8.        _{plastic cowling / engine housing.}
10. Type of equipment
11. Equipment manufacturer
12. Engine received mounted detached
13. Hours used
14. Units originally sold by
15. Purchase Date
    / /
    
16. Failure Date
    / /
    
17. Repair Date
    / /
    
18. Condition found/cause of failure
19. Work performed
20. Freight postage cost $
21. Labour cost

    	Hrs	Mins	Job #
    Repair 1
    Repair 2
    Repair 3
    Total

22. Part numbers used to repair

    Part Number	Qty	Description

    More parts
      a
23. Tax Invoice Number: SLI
24. Tax Invoice File
    _{(Please upload your original Tax Invoice as a PDF, JPG or GIF file.) Max Size: 1MB}
27. Warranty ID number
28. Authorisation No.
    _{( only required for engines / short blocks)}
30.  

    Please enter the word you see in the image below

     

    

     

31.