Purchased Item:
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--Select--
Date of Purchase
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pick
Place Of Purchase
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Order No
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Please Select Reason          (Select One)
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Doesn't maintain voltage between uses
Poor cranking performance
Battery lost power while riding
Would not start shortly after riding
Physical battery case damage
SELECT IF CHARGER or if BATTERY - OTHER – Explain in Comments Below
Please Select Reason If Charger           (Select One)
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Battery went dead with charger connected in Store Mode
When connecting the battery to the charger -- alternating yellow/green lights
No lights come on after plugging in charger
Both Lights Flash Once then Pause
Both Lights Flash Twice then Pause
Both Lights Flash Three times then Pause
Both Lights Flash Four times then Pause
Questions/Comments:
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Last Name
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Address2 :
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State :
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Email
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Confirm Email Address
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Vehicle Type
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--Vehicle Type--
ATV
Motorcycle
Personal Watercraft
Riding Lawnmower
Scooter
Utility Vehicle
Make
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--Make--
Year
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--Year--
Model
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--Model--
My Vehicle/Application is not on the List :
(if yes) Is this ALSO a Powersports Vehicle :
Lot Number:
Standard Battery :
Duration Battery :
Have you attempted to charge the Battery? :
--Select--
Yes
No
Credit Card
Card Type
*
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--Select--
American Express
Discover
Master Card
VISA
Card Number
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CVV
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Expiry Date
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--Select--
01
02
03
04
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09
10
11
12
--Select--
Billing Zip Code:
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Approve Replacement (proration may apply):
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Feb
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