Submit a Request for Warranty Reimbursement

Form Instructions

Please follow the instructions below for warranty consideration.
Must have authorization number before warranty work can be performed.
Must have description of repairs & estimate of parts and labor.
This warranty request will be evaluated and you will be contacted with an authorization number (entered above), if approved for making necessary repairs.
Digital photos of the problem are important and should be emailed to our Warranty Dept at warranty@talbertmfg.com.

Personal Information

Requestor:

Company:

Phone:

Fax No:

Email:

Warranty Information

Serial Number

At minimum, the last (5) five digits must be provided.

Make:

Model:

If other, please describe...

Year:

Mileage:

Color:

Date put in service:

Description of repairs needed:

Total Labor Hrs:

Labor Rate:

Parts Cost:

Total:

End User

End User's Name:

Address:

City:

State:

Zip:

Contact:

Ph. No:

Fax No:

Talbert dealer doing repairs

Name of dealer:

Address:

City:

State:

Zip:

Contact:

Ph. No:

Fax No:

Security code

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