Warranty Claim Form All fields must be completed or claim will be denied.                                       Date: "; if (isset($van[2])) { $display_form1 .= "  "; } else { $display_form1 .= "  "; } $display_form1 .= "                                                                                                               Warranty Claim No. $van[1]   Customer Reference #:                                           Customer/Dealer Information CC RT HX PT EM Parts Dealer ID:                                               Name:   Address:   City:   St:   Zip:   Phone:   Fax:     Applicant:   Signature:   Manager:   Signature:                                                                 Machine  Information   Serial# "; if (isset($van[17])) { $display_form1 .= " "; } else { $display_form1 .= " "; } $display_form1 .= " Hours:   Model:   Product:   Date of Commissioning   Report Date:   Description of failure:   Problem Type: LABOR Date From / to Travel From/to Mileage Labor Lodge Meal Others Cost Adjust "; $nbr_ligne=$nbr_ligne1; //$nbr_ligne=2; // if ($nbr_ligne=$blink){ //$nbr_ligne=0; // } $m=19; for ($i=0; $i<$m; $i++) { $j=$i+1; // Display only the first line if ($nbr_ligne == 0) { $nbr_ligne = 1; } if ($i >= $nbr_ligne) $display = 'style="display:none"'; // $prod22A .=" [+] ADJ: ADJ: ADJ: ADJ: ADJ: "; } $display_middle .=" PARTS Qty Part number Description Invoice # Unit Cost Total Cost Adjust "; $display=''; $nbr_ligne=21; //$nbr_ligne=2; // if ($nbr_ligne=$blink){ //$nbr_ligne=0; // } $m=40; for ($i=20; $i<$m; $i++) { $j=$i+1; // Display only the first line if ($nbr_ligne == 0) { $nbr_ligne = 21; } if ($i >= $nbr_ligne) $display = 'style="display:none"'; if(${PA.$i} != $blink){ $display = ''; } // $prod22B .=" [+] "; } $prod22.="$prod22A $display_middle $prod22B"; if($van[36]==1){ $checkA="checked"; } if($van[36]==0){ $checkB="checked"; } if($van[35]==1){ $singA="checked"; } if($van[36]==0){ $singB="checked"; } $siggy .=" Claim:   Approved   Not Approved   President approval: Yes No Date: "; $display_form2 .="   Total labor cost of repairs work only:   Labor Cost ADJ Total cost of part(s) used in repairing unit:   Parts Cost ADJ Total amount claimed, parts and labor combined:   Total Cost ADJ Please Submit to: warranty@sanyamerica.com                                           Service Manager:   Comments:   Service & Parts Dept.:   Comments:   Financial Dept.:   Comments:   Presidents office use only   $siggy Comments:      

318 Cooper Circle South | Peachtree City, GA 30269                    "; ?>