KSAP Labor Claim Request Form Required fields indicated with * h Salesperson Warehouse Date * Customer * Contact * Address Acct# Phone# * City State Zip Fax# E-mail Address * Labor Rate Per Hour: $ * VEHICLE INFORMATION: Year * Make * Model * VIN# * Engine Displacement * Auto/Manual Trans * 2WD/4WD/AWD * Select One * 2WD 4WD AWD Mileage At First Repair * Date of First Repair * Mileage At Second Repair * Date of Second Repair * Mileage At Third Repair Date of Third Repair Original Tech`s Name * FAILED PART: Manufacturer * Part# * Associated Parts Description Of Failure (Required) REQUIRED COPIES: Original RO Repair RO Tow Bill Disclaimer * Please note, to be considered for a labor claim, a customer must average $1500 in monthly purchases. ** Customer account must be in good standing. To prove you are a human, please tell us which has four legs? Please answer question. Octupus Table Spider Please wait. Your request is processing.