Warranty Claim Form

Thank you for being an AtlasIED customer. We value your business and partnership. In an effort to process your claim as quickly and accurately as possible, please fill out the form below.

Customer Info

First Name

Last Name

Phone Number

Company Name

Street Address

City

Zip/Postal Code

Country

Drop Ship to Address same as above

Type of Business

Company or School name

Optional

Platinum Assurance Plan Subscriber

Best Way to Reach You

Optional

If you don't know who your local AtlasIED manufacturer's rep firm is, you can view the territory map HERE.

AtlasIED Account #

Optional

AtlasIED Rep Firm

Optional

Return Information

Return Type - Warranty Claim

Receipt Type

Sales Order/Purchase Order/Invoice Number

Date of Purchase

PDF Sales Order/Purchase Order/Invoice Upload

File