Formulaire

Kidde Claim Form

Preferred method for submitting BULK claims is to use the claims template on the main warranty page.

  1. Customer Information
  2. Product Information

Customer Information

Please avoid using special characters as they will cause the form to error.

Customer Name null
Customer Number
City
State
Country
Submitter Name null
Email null
Phone
Claim Number Non-Collins Claim ID null
Purchase Order/Repair Order null
Contract Applied Contract Name: PSAA, SSC,... null
Letter of Delegation on File
Letter of Delegation on File
Removal: A/C Type null
Removal: A/C Serial #
Removal: A/C Tail # null
Original Fit: A/C Type or Spares PO null
Original Fit: Serial #
Original Fit: Tail # Type N/A for Spares PO null
Manufacturer's Part # One Collins Part per claim null
Old/Removed Serial # One Collins Part Number per claim null
New /Installed Serial # One Collins Part Number per claim null
Parts: Part Number Hit ENTER to add more than one part.
Parts: Quantity Hit ENTER to add more than one part.
Parts: Price per Unit Hit ENTER to add more than one part.
Parts: Total Amount Hit ENTER to add more than one part.
Date of Failure null
Date of Repair
Complaint Please avoid using special characters as they will cause the form to error.
Corrective Action Please avoid using special characters as they will cause the form to error.
Notes Please avoid using special characters as they will cause the form to error.

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Template Language

Note: Templates are best used when submitting batch claims of registration\retrofits that involved multiple equipment types.

Templates for Batch Claims/Registrations

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