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