Warranty Claim Form Home Current 1) Address 2) Service, Attachment, & Truck Info 3) Claim Info, Replaced Parts, & Work Info 4) Summary 5) File Attachments 6) Confirmation Dealer Address Dealer Address Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta and MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian territoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Vincent and the GrenadinesSaint-BarthélemySaint-Pierre-et-MiquelonSamoaSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Outlying IslandsUS Virgin IslandsUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe First name Last name Organization Street address Street address line 2 Street address line 3 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)CaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMicronesiaMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip code Phone: E-Mail: End User End User Address Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta and MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian territoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Vincent and the GrenadinesSaint-BarthélemySaint-Pierre-et-MiquelonSamoaSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Outlying IslandsUS Virgin IslandsUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Organization Street address Street address line 2 Street address line 3 City Postal code Service Information Service contact: Did your branch complete the repair? - Select -YesNo Servicing dealer: City, State, Zip: Attachment Information Model/Catalog Number: Serial Number: Installation Date: Failure Date: Date Dealer Completed Repair: Truck Information Truck Make and Model: Truck Serial Number: Warranty Truck Hours: Claim Information Customers Complaint: Was this issue discussed with a Cascade Technician: - Select -YesNo If yes, name of the Cascade Service Technician: Did your service technician issue an RGA or Service Ticket? - Select -YesNo What is the RGA or Service Ticket number?: Cause of problem: Repair work performed: Replaced Parts Replaced Parts Qty Part Number Name/Description Cost Per Unit Dealer PO# Operations Qty Part Number Name/Description Cost Per Unit Dealer PO# Qty Part Number Name/Description Cost Per Unit Dealer PO# Qty Part Number Name/Description Cost Per Unit Dealer PO# Work Order Information Labor hours claimed: Travel hours claimed: Total travel and labor hours: Posted Retail Labor rate: Claim, work order or invoice number: Adjusted Labor rate: *Cascade Warranty pays 70% of your posted labor rate. Dealer Information Address Phone: E-Mail: End User Information Address Service Information Did your branch complete the repair? Servicing dealer: City, State, Zip: Attachment Information Model/Catalog Number: Serial Number: Installation Date: Failure Date: Date Dealer Completed Repair: Truck Information Truck Make and Model: Truck Serial Number: Warranty Truck Hours: Claim Information Customers Complaint: Was this issue discussed with a Cascade Technician: If yes, name of the Cascade Service Technician: Did your service technician issue an RGA or Service Ticket? What is the RGA or Service Ticket number?: Cause of problem: Repair work performed: Replaced Parts QtyPart NumberName/DescriptionCost Per UnitDealer PO# [webform_submission:values:replaced_parts_row] Work Order Information Labor hours claimed: 0 Travel hours claimed: 0 Total travel and labor hours: Posted Retail Labor rate: 0 Claim, work order or invoice number: Adjusted Labor rate: *Cascade Warranty pays 70% of your posted labor rate. File Attachments Status message Attach pre-repair photos and work orders to help expedite warranty processing. Status message Attach up to three supporting documents or photos here. Status message Total size of all uploads can not exceed 10 MB (10,000 KB). File upload One file only.10 MB limit.Allowed types: jpg, png, pdf, doc. File upload One file only.10 MB limit.Allowed types: jpg, png, pdf, doc. File upload One file only.10 MB limit.Allowed types: jpg, png, pdf, doc. Status message File claims within 30 days of completion of repair. Status message Identify product by Cascade Serial Number. (Only those properly identified can be considered for warranty.) Status message Cascade new product warranted for 36 months from the date of installation. Cascade Remanufactured product warranted for 12 months from the date of installation. Cascade Certified Used product are warranted for 6 months from date of installation. Please limit claims to the warranty period. Status message Retain all parts until you receive an RGA (return goods authorization) from Cascade.
