Honeywell Lighting & Electronics
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Lighting & Electronics >Customer Service Center >Third Party Warranty Form}
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* Indicates Required Field. You can print a copy for your records.
Customer Information
Company Name *   Please refer to the below listed numbers
on all correspondence.
Fax *  

Claim Number *
Address *
Point of contact *
E-mail *
Phone *
 
Claim Information
* Date claim prepared (mmddyy)
* GRIMES Part Number
* Part Description
* AIRCRAFT Type
* ENGINE Type

Unit Information
* Date of Unit Manufacture (mmddyy)
* Serial Number
* Aircraft Delivery Date (mmddyy)
* Installation
(If original equipment, use Aircraft delivery date)
* Removal
Date (mmddyy)
A/C Hours
Date (mmddyy)
A/C Hours
Reason for Removal
* Select one of the Removal Reasons below:
Please provide a detailed description of the reason for removal:
Shop/Line Findings
* Select one of the Shop/Line Findings below:
Please provide a written failure analysis and repair action:

Materials Used in Repair

*At least one row must be complete.


1. Provide Quantity Used & Unit Prices for part numbers in repair.
2. Press the Calculate Material Cost button below to fill totals into the Extended Cost column.
QTY Used
GRIMES Part Number
Description
Unit Price
Extended Cost
:
 

Labor Cost

Fill out "Time in Hours" and "Labor Rate" then press "Calculate"
Time in Hours
Labor Rate
Cost
Removal/Reinstallation
Direct Repair
SUB-TOTAL
   
     
SHIPPING COST:  
Total Repair & Labor Costs    

 

 

Please verify data & totals before submitting. Thank you.