WARRANTY CLAIM

1. Warranty performed by

2. Account Number:

3. Name:

4. Address:

5. Suburb:

6. State: Please SelectNSWQLDVICWASATASNTACT

7. Postcode:

8. Phone Number:

9. Email Address:

1. Owner of machine

2. Commercial Use: Please SelectYesNo

3. _{Please note:
   Use may affect warranty length, please confirm machine use before placing a claim.}

4. Name:

5. Address:

6. Suburb:

7. State: Please SelectNSWQLDVICWASATASNTACT

8. Postcode:

9. Phone Number:

2. Petrol or Diesel Claim Please SelectPetrolDiesel

3. Engine model No

4. Spec No or K-Number
   

5. Engine Serial Number

6. _{Please note:
   Petrol engines 10 digits, Diesel engines 7, 8 or 10 digits.}

7. _{Please note:
   Petrol Engine Serial Number can be found on the black plastic cowling / engine housing.}

8. 
   

9. Type of equipment

10. Equipment manufacturer

11. Engine received Please Selectmounteddetached

12. Hours used

13. Units originally sold by

14. Purchase Date

15. Photo Of Engine ID Sticker/Plate:

    ❌

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

*Do not include travel time with labour cost.

Travel Requirements

	Time Travelled (hrs)	Kms Travelled
Details

Pre-approval over 50ks distance is required by the EPG warranty division

22. Part numbers used to repair

    Part Number	Qty	Description

    More parts

     

23. All parts must be purchased from EPG Engines to be a valid warranty claim. Unless written proof from an EPG member is provided

24. Tax Invoice Number: SLI
    

25. Tax Invoice File
    _{(Please upload your original Tax Invoice as a PDF, JPG or GIF file.)}
    

    ❌

    
    _{Max Size: 2MB}

28. Warranty ID number
    

29. Authorisation No.
    _{( only required for engines / short blocks)}
    

30. Serial Number of New Engine
    

32.