Service Bulletin B06-01 Warranty Claims Form

Superior Customer Account Number
Security Assurance Plan Warranty Number
Date of Occurrence
OWNER OR OPERATOR
Name
Country
Address
City
State
Zip
Phone
Email
Contact E-Mail
US Mail
Both
REPAIR AGENCY
Name
Country
Address
City
State
Zip
Phone
Email
Contact
Customer's description of difficulty
AIRCRAFT INFORMATION
Aircraft Make
Aircraft Model
Registration Number
ENGINE INFORMATION
Engine Make
Engine Model
Engine Serial Number
Date Failed Part Was Installed
Total Time On Failed Part hrs


PART INFORMATION
Part Number Serial # Description


Please recheck all data. Once form is submitted successfully you must contact Superior for further changes.