Online Warranty Form

Please fill out completely and include copy of the original receipt with this form. After review, EarthX, Inc. will contact you with a return authorization.

Customer Information

Name(Required)

First Last

Ship to:(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Enter Email Confirm Email

What Product Do You Have?(Required)

What Type of Vehicle is the battery in?(Required)

Reason for returning the product (please describe):

If you are an authorized dealer, please fill in your dealership name:

Product Specific Information

Battery Serial Number located on the backside of the battery(Required)

What is the manufacturer code?(Required)

The manufacturers code is on the reverse (back) side of the battery, just below the negative terminal as pictured here.

Vehicle Make(Required)

Vehicle Model(Required)

Vehicle Year(Required)

Engine Type(Required)

What is the max output of the alternator/generator?(Required)

1) What is the current voltage at the terminals for the battery using a voltmeter?(Required)

Please provide your answer in volts.

2) Has the battery ever been charged by an external charger?(Required)

Yes

What brand or type of external charger did you use? (if any)(Required)

What was the result of charging the battery?(Required)

Hidden

3) Did you ever jump start the battery from an automobile?(Required)

Yes

Receipt

Attach your scanned receipt here.

Drop files here or

Accepted file types: jpg, pdf, tif, doc, docx, Max. file size: 5 MB, Max. files: 3.

If you have your reciept, please scan or take a photo of it and upload it in one of the following formats: jpg, pdf, tif, doc, docx

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Name

This field is for validation purposes and should be left unchanged.

Customer Information

Product Specific Information

Receipt

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