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CWS Web ID: 140637406
CWS Claim Number:
Distributor:
     Date: 08/20/2008
City:
Phone Number:
Fax Number:
Email: [required]
Dealer Claim Number:
Machine Model Number:
Machine Serial Number:
Completed By:
End User:
Product Description:
Attachment Serial Number:
In-Service Date:
Date of Failure:
Key Part of Failure:
Nature of Failure:
Hours in Use:
Were replacement parts purchased from CWS?

Parts Claimed
Part Number:
Quantity:
Description:
Invoice Number:
Net Cost:


Part NumberQuantityDescriptionInvoiceCostRemove




Total Hours:
Total Cost of Labor:
Total Cost of Parts:
Sublet Labor:
Net Claim Total:
Have The Defective Parts Been Returned to CWS?:
Have All Documents Been Emailed to CWS?:
Shipping Company:
Shipping Account
Number:
Shipping Date:
Please upload any supporting photos and documents.
Uploaded Files:
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