Details of Repair, if any_____________________________________________________________________________
Note:
Please contact nearest respective authorised battery dealer for details immediately after purchase of
vehicle.
Name of Dealer & Code :____________________________________________________________________
____________________________________________________________________________________________
Date of claim :________________________________________________Battery Type :_________________
Serial No. :__________________________________________________Date of Fitment :________________
TO BE FILLED IN BY BATTERY DEALERS / DISTRIBUTORS
IN CASE OF CLAIM
# Claim Accepted
## Claim Rejected
Failure Mode (Please tick as applicable)
• Loose connection • Overcharge / Undercharge
• Internal Short • Reverse Charge
• Plate Shedding • High Specific Gravity Electrolyte
• Intercell Connection • Electrolyte Contamination
• Does not Hold Charge • Electrolyte Level not Maintained
• Wrong Assembly • Left Lying Idle
• Wrong Application
• Terminal Corroded
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