Warranty claim form: proof, model and fault in one submission

A warranty claim form records the product and model, the proof of purchase, the date the fault appeared, and a description of the fault that a reviewer can check against the warranty terms. The claim is a request for review, so the form should gather evidence rather than decide coverage. Ask for proof and a specific fault description in the first submission, so the reviewer does not have to restart the process by email.

A filled example

A completed claim, with the reviewer's note (fictional)

Example only, not a real submission

Product
Cordless drill, model DX-200
Date of purchase
2 May
Proof of purchase
Store receipt, kept by the customer
Fault
The battery stops charging after about ten minutes of use, and the charger light stays on.
Repairs or changes so far
None
Reviewer note (internal)
Compare the purchase date with the warranty period for this model. If the terms require it, ask for a short video of the fault through your own channel.
Field blueprint

Evidence and fault details a reviewer can check

FieldTypeRequiredWhy you ask it

Full name

Short textRequired

Matches the claim to the buyer, since some warranties name the original purchaser.

Email address

EmailRequired

Where the decision, and any request for missing details, will be sent.

Phone number

PhoneOptional

A second route for an urgent case, such as a tool that has stopped working on a job site.

Product name

Short textRequired

Matches the product to the warranty terms written for that range.

Model number

On the label or in the box. Do not guess.

Short textRequired

Shows which warranty term applies, since one product name can cover several models.

Serial number

Usually printed near the model number.

Short textOptional

Identifies the unit, so repeated claims on one item are visible.

Date of purchase

DateRequired

Starts the check against the warranty period. The proof of purchase should show the same date.

Where you bought it

Short textOptional

Identifies the seller, who may handle the claim under its own terms.

What proof of purchase do you have?

A receipt or invoiceAn order confirmationNo proof
Single choiceRequired

States what the customer can provide now. The reviewer decides whether that is enough under your terms.

When did the fault first appear?

DateOptional

Separates a fault present from the start from one that developed later, which your terms may treat differently.

Describe the fault

Say what you see or hear, when it happens, and what you have already tried. Do not guess the cause.

Long textRequired

The fault in the customer's words. A specific detail, such as an error light or a noise at a set point, lets a reviewer check the claim.

Has anyone repaired or changed the product?

NoYes, our teamYes, someone elseNot sure
Single choiceRequired

A repair by someone else can affect a warranty, so the reviewer needs to know before deciding.

What would you like us to do?

RepairReplaceRefundNot sure yet
Single choiceOptional

Records the request. Your warranty terms decide which of these each claim can receive.

Try it

Preview the claim before you publish it

Preview · not a real form

On the label or in the box. Do not guess.

Usually printed near the model number.

What proof of purchase do you have? Required

Say what you see or hear, when it happens, and what you have already tried. Do not guess the cause.

Has anyone repaired or changed the product? Required
What would you like us to do?
After a response arrives

From a saved claim to a decision

  1. Compare the proof and the period first

    Check the purchase date and the proof against the warranty terms for that model before you decide anything. A claim outside the period, or without proof your terms accept, needs a written reason.

  2. Ask for missing details outside the form

    The form cannot accept attachments. When proof or a photo is missing, reply to the claimant from your own mailbox or queue and name exactly what you need.

  3. Check the grid for repeat faults

    Before you decide, look for earlier claims on the same serial number in the grid, so a repeat fault on one unit is not missed.

  4. Know who hears about each submission

    Only the form's creator receives a notice, and only after the hourly production job has run. A customer who expects an acknowledgement right away will not get one from the form itself.

Working checklist

Deciding a claim consistently

Before you decide

  • The model number matches the product described in the claim
  • The purchase date falls inside the warranty period for that model
  • The proof of purchase is readable and shows the same date
  • The fault description is specific enough to check

If you decline

  • Quote the warranty term that excludes the fault
  • Offer the customer a chance to add missing details
  • Write the decision in plain words the customer can follow

After the decision

  • Record the outcome in your own system
  • Export the month's claims and count faults by model
  • Review the form whenever your warranty terms change

Frequently asked questions

What should a warranty claim form include?

The product and model number, the date of purchase, the proof the customer has, a specific description of the fault, and what they want done. Add a name and a reply route, so you can ask for missing details without starting again.

Is there a warranty claim form template I can use?

Use the fields in this guide as the template, and match the proof question to what your warranty terms accept. Name the model and the warranty period in your own terms, so the reviewer can check each claim against a written rule.

Can customers attach photos to a warranty claim?

Forms built in Attain OS cannot take photos or other files. Ask for them through your team's usual channel once you have read the claim.

Should a warranty claim ask for a serial number?

Yes, when the warranty depends on the individual unit. If your products have no serial numbers, remove the field. Otherwise, say where the number is printed so people can find it.

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How to build it

  1. Choose a category and a form type in the wizard. Answer three Atty Suggestions questions, then give the form a title. Atty builds the fields in the background. Edit the fields and ask Atty to refine them, then publish and share the /f/ link.

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