Warranty Form

City*

Province*

Postal Code*

Phone Number*

Email*

Customer/End User Information

Customer/End User Name*

City*

Province*

Postal Code*

Phone Number*

Email*

Appliance Brand*

Appliance Model No.*

Appliance Serial No.*

Was the appliance installed in a vehicle*

Recreational Vehicle/ Manufactured Home Manufacturer:

Detailed Service Problem

*Enter as much information as possible - Missing Information May Result In Processing Delays*:

Date of Purchase/Installation*

Date of Complaint*

Has the service been completed*

Attachment section

Choose File

Type of use:

Parts Section

Fill Out Part Numbers For Repair If Known
All warranty parts to be supplied by GLP. We do not issue payment for replacement parts purchased elsewhere.

Parts Number

Parts Description

Parts Number

Parts Description

Parts Number

Parts Description

Parts Number

Parts Description

Labour Section

Total Amount (Do Not Include HST)

KM (inquire if applicable)

Please indicate if reimbursement is to anyone other than the contractor/service center:

City

Province

Postal Code

Phone Number

If you are new to GLP Canada, please provide us with your banking information so we
can set you up in our system and reimburse you in a timely manner. Send us your banking
information at: ap@glpcanada.com

Coast-to-Coast Repair and Warranty Service

Service Centre Information

Customer/End User Information

Appliance Brand*

Appliance Model No.*

Appliance Serial No.*

Was the appliance installed in a vehicle*

Detailed Service Problem

Has the service been completed*

Type of use:

Parts Section

Labour Section

Please indicate if reimbursement is to anyone other than the contractor/service center:

Warranty Form

Coast-to-Coast Repair and Warranty Service

Service Centre Information

Customer/End User Information

Appliance Brand*

Appliance Model No.*

Appliance Serial No.*

Was the appliance installed in a vehicle*

Detailed Service Problem

Has the service been completed*

Type of use:

Parts Section

Labour Section

Please indicate if reimbursement is to anyone other than the contractor/service center:

Register a product warranty

Customer Information