Repair Order Review Request Form

For assistance with completing this form

> Call: 1.800.852.6298
> Email: customer service

Repair Order Review - Request Form

Be 100% confident in your warranty claims for a small investment of $395! Much less than the cost of any factory audit.

Yes, I’m interested in having J&L Warranty Pros conduct a Repair Order Review!

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1. Please select your franchise:
GM Chrysler Ford

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3. Dealership information:
* Dealership Name: * Mailing Address: * City:
* State/Province: * Zip: * Email:	* Phone: Phone Extension: Fax:
Shipping Address (if different from mailing): City:
State/Province:	Zip:

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4. Reason for interest in this service: (i.e. high warranty expense)

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* 5. Discounts: If you received a direct mail piece please provide the offer code to apply any applicable discounts.
OC# (Found near phone # or mailing label)
If you didn't receive a direct mail piece (postcard / letter / flyer), how did you know to seek J&L Warranty Pros for help?
	Other:

	Once you submit this form, you will be contacted by a warranty claim specialist to discuss the service further.