Personal Information:

First Name *

Last Name *

Phone Number *

Email Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *

Tire Information:

Tire Model *

Tire Brand *

Tire Size *

Date of Purchase *

Place of Purchase:

Quantity *

Proof of Purchase: *

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-1_

Warranty Claim Details:

TIRE #1

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-2_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-3_

If you have additional DOT Code / Quantity combinations, please enter them below...

Additional DOT Code 2

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-8_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-9_

Additional DOT Code 3

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-10_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-11_

Additional DOT Code 4

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-12_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-13_

Additional DOT Code 5

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-14_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-15_

Additional DOT Code 6

DOT Serial Number (found on the sidewall of the tire): *

Please Insert a Sample image of DOT here

Describe the issue you are experiencing with the tire(s): *

Upload a photo of the Tire’s Sidewall (showing the complete DOT) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-6_

Upload a photo of the damage or issue with the tire(s) (if applicable) (JPG, PNG):

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-7_

Enter your dealer information

Dealer Name *

Date Of Purchase *

Address *

City *

State *

Zip Code *

Country of Purchase

Did you purchase road hazard insurance with your tires ?

Vehicle Information:

Vehicle (Year/Make/Model): *

Upload a Photo of the Tire on the Vehicle:

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-4_

Approximate mileage on the tire(s) at the time the issue occurred: *

Proof of Tire Alignment and Rotation every 3k-4k miles:

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-136608-file2-5_

Have you noticed any punctures, cuts, or damage to the tire(s)? (Yes/No)

Additional Comments:

Is there any additional information you would like to provide regarding your warranty claim?

By submitting this form, I certify that the information provided is accurate to the best of my knowledge. I understand that submitting false information may void my warranty claim. I agree to comply with any further instructions provided by the warranty department.

Signature: *

Date *

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Claim your Warranty

Personal Information:

Tire Information:

Warranty Claim Details:

If you have additional DOT Code / Quantity combinations, please enter them below...

Enter your dealer information

Vehicle Information:

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