Ford Warranty Claim Form

Please review the Warranty Terms & Conditions prior to submission.

Dealership Name *

Dealership Street Address *

Dealership Suburb *

Dealership State *

Dealership Post Code *

Name *

Phone *

Please Include Area Code (e.g. 03 for Victoria)

Email Address *

Date of Invoice *

Invoice Number *

Vehicle VIN *

Vehicle Model *

Engine Part Number – RangerShortlisted based on model

Engine Part Number – EverestShortlisted based on model

Engine Part Number – TransitShortlisted based on model

Engine Part Number – MustangShortlisted based on model

Date of Engine Fitment *

Day

Month

Year

Vehicle Kilometers at Fitment *

Current Vehicle Kilometers *

Vehicle Maintenance Detail *

Full service history must be provided!

Detailed Description of Customer Concern *

Please supply at least 3 supporting images + any other relevant attachments

e.g. audio files etc