Waldon Manufacturing, LLC
201 W. Oklahoma Ave.
Fairview, OK 73737
580.227.3711
866.283.2165
WALDON WARRANTY CLAIM FORM
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Claimant:
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Owner:
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Address:
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Address:
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City:
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City:
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State:
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State:
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Zip Code:
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Zip Code:
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Phone:
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Phone:
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Email Address
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Unit Serial Number:
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Authorization Number:
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Date in Service:
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Date Repaired:
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Hour Meter Reading:
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Labor Rate:
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Details of Owner Complaint
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What Failed (Include Description, Part Number, Part Cost)
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Service Work Performed (Include Description & Labor Hours)
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Select Reimbursement Method
Credit Account
Pay by Check
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Total Claim Amount:
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Account Number
