Warranty Claim Form

To submit a warranty claim, please complete this form. All bold fields are required.

Service Center Information
ID:
Name:
Address 1:
Address 2:
City:
State/Region:
Zip/Postal Code:
Country:
Failure Date: Pick a date
Repair Date: Pick a date
Work/Invoice Number:
Sales/Purchase Order Number:
RMA Number:
 
If unit was not returned, input "None"
Registered Owner Information
Customer Name:
Address 1:
Address 2:
City:
State/Region:
Zip/Postal Code:
Country:
Customer Telephone:
Customer E-mail:
Aircraft Registration
(Tail Number):
Aircraft Serial Number:
Aircraft Make/Model:
Aircraft Hours:
Unit Model:
Unit Part Number:
Unit Serial Number:
Unit Software Level:
Repair Information
Hours:
Current Rate
(In US Dollars):		 $
Shipping Cost: Return shipping charges are no longer covered by the Avidyne warranty policy, please see updated Service Pricing Matrix [PDF] for further details.
Total Repair Cost: $
Complaint:
Corrective Action:
Submission Information
Submitted By:
E-Mail Address:
Submission Date: Pick a date
Telephone:
Additional Information:
 

 

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Warranty Claim Form

 

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