Search Inventory Careers Bill Pay JX Warranty Claim Form JX Warranty Claim Form-2017-R2 Customer Information Sponsoring Branch* Fleet Name* Acct Number* Fleet Contact Name* Phone* Email* Vehicle Information Work Order/RO#* Date of Failure* MM slash DD slash YYYY Make* Mileage @ Time of Failure* Vehicle Serial Number* Complaint Cause Investigation Correction Claim Information Total Repair Hours Claimed Labor Rate per/hr Parts Number Description Qty Price Ea. Total Sublet Invoice Info List $ Amt (USD) Description Total Labor Total Parts Total Sublet Claim Total Attach Supporting Files Drop files here or SELECT FILES Accepted file types: pdf, docx, jpg, png, doc, gif, Max. file size: 200 MB. Signature* Email* COMPANY About JX JX Gives Back Newsroom JX Blog Our Purpose Our Reviews JX Way VISIT OUR DEALERSHIPS Bloomington, IL Bolingbrook, IL Champaign, IL Elmhurst, IL Effingham, IL Lansing, IL Rockford, IL Wadsworth, IL Chicago, IL Morton, IL Fort Wayne, IN Indianapolis, IN Hickory Hills, IL Lafayette, IN Grand Rapids, MI Kalamazoo, MI Gaylord, MI Niles, MI Marquette, MI Mt Pleasant, MI Appleton, WI Green Bay, WI Madison, WI Milwaukee, WI Mineral Point, WI Waukesha, WI Wausau, WI SERVICES Truck Sales Leasing Rental Financing Service Parts Body Shop Graphics CONNECT Contact Us Warranty Claim Form Email Signup © 2016 JX Enterprises, Inc | All Rights Reserved | Privacy Policy | Terms & Conditions