Samsung HVAC Warranty Claim Form

Samsung HVAC Warranty Claim Form


***(Must be filled out COMPLETELY and LEGIBLY)***

  • DISTRIBUTOR:

  • - -
  • - -
  • / /
    Pick a date.
  • Ship replacement parts to:

  • - -
  • - -
  • End User Information:

  • - -
  • Servicer:

  • - -
  • Equipment:

  • Serial Number:

  • / /
    Pick a date.
  • / /
    Pick a date.
  • Parts Information #1:

  • Parts Information #2:

  • Parts Information #3:

  • All warranty components will be shipped to Samsung parts distribution centers only.

  • By clicking submit, you are acknowledging the information entered on this warranty claim is true and correct.  Any incorrect of false data may lead to a delay or cancellation of this warranty claim.