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By completing this form, you have requested your warranty claim be reviewed. If determined that that product failure has occurred within the applicable warranty period and is a result of a defect in materials or workmanship, a corrective action will be assigned and a Customer Service Representative will contact you regarding the warranty fulfillment process.

Warranty Policy

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Is ship-to address is different from above

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Address*

Name/Company Name Address City State / Province / Region ZIP / Postal Code

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Products Purchased

Distributor Purchased From:*

Approximate or Exact Date of Purchase*

Detailed explanation of what caused the damage.*

Qty and Part Number or Description of damaged pieces.*

Qty.	Part Number

Seat Serial # (Either a 6 digit # found on the front left side of the seat base -OR- 10 digit # found on the left side of the seat base)

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Warranty Claim

Products Purchased

2701 SW 18th St. P.O. Box 740 Owatonna, MN 55060 Phone: 1-800-248-3855

2701 SW 18th St.
P.O. Box 740
Owatonna, MN 55060
Phone: 1-800-248-3855