Return Form

Customer Info

COMPANY (OR CUSTOMER) NAME*

CUSTOMER #

STREET ADDRESS*

CITY*

STATE*

ZIP CODE*

PHONE NUMBER*

EMAIL*

Order Info

(If warranty, a replacement will be requested.)
REQUEST TYPE*
ReturnWarranty
CUSTOMER #

PURCHASE DATE*

PO NUMBER

INVOICE #*

Y.E.S. PLAN SERIAL #

LIST OF PRODUCTS TO RETURN, PLEASE INCLUDE PART #*

Vehicle Info

(REQUIRED for All Warranty Returns)

MAKE, MODEL, YEAR

ENGINE SIZE

TIRE SIZE

LIFT

TRANSMISSION

PRIMARY VEHICLE USE

REASON FOR RETURN*

RETURN POLICY*
I have read and understand the Returns Policy for Jim's Drive Train