Leopard Warranty Claim Form

Warranty Claim Submission
Submission Date

DayMonthYear
Hour MinutesAM/PM Option
Yacht Name*
Yacht Current Location*
Yacht Builder*
Model*
Hull Identification Number:*
Beginning with ZA-RA/ IRIS/ FR/ BEY etc
Build Year*
Builder ID*
number begins with B followed by 4 digits example B9008
Name of submitter :*
Submitter Email*
example@example.com
type*
Sales Region*
Region where yacht was purchased
taskNumber
From
Title
Agent Email
token

Fault 1 - Claim Type*
Fault 1 - Category*
Fault 1 - Failed Part*
Example – Locker lid etc
Fault 1 - Part Failure*
Example – cracked etc
Fault 1 - Location*
Does this require labour?*

YesNo
Does this Fault 1 require a replacement part?

YesNo
Do you know the part number?

YesNo
Part Manufacturer
Part Model
Part Serial Number
Fault 1 - Any Further Details of the Failure

0/250
Take a Photo of damaged part
Upload Fault Images & Any Estimates

Upload the image of damaged part
Cancelof
Other Fault

Add Fault 2
click on “Next” to add Fault 2 Page

Fault 2 - Claim Type*
Fault 2 - Category*
Fault 2 - Location*
Fault 2 - Failed Part*
Example – Locker lid etc
Fault 2 - Part Failure*
Example – cracked etc
Does this require labour?*

YesNo
Does this Fault 2 require a replacement part?

YesNo
Do you know the part number?

YesNo
Part Manufacturer
Part Model
Part Serial Number
Fault 2 -Any Further Details of the Failure

0/250
Take Photos of damaged part
Upload Fault Images & Any Estimates

Upload the image of damaged part
Cancelof
Back to Fault 1

Remove Fault 2
Other Fault

Add Fault 3
click on “Next” to add Fault 3 Page
click on “Back” to Remove Fault 2 Page

Fault 3 - Claim Type*
Fault 3 - Category*
Fault 3 - Failed Part*
Example – Locker lid etc
Fault 3 - Part Failure*
Example – cracked etc
Fault 3 - Location*
Does this require labour?*

YesNo
Does this Fault 3 require a replacement part?

YesNo
Do you know the part number?

YesNo
Part Manufacturer
Part Model
Part Serial Number
Fault 3 - Any Further Details of the Failure

0/250
Take Photos of damaged part
Upload Fault Images & Any Estimates

Upload the image of damaged part
Cancelof
Back to Fault 2

Remove Fault 3
click on “Back” to Remove Fault 3 Page

Agent Assessment
Currency Type*
CLAIM TOTAL ESTIMATED HOURS
CLAIM TOTAL ESTIMATED COST
Submission Response
Please verify that you are human*
Should be Empty: