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Honda Philippines, Inc.


DEALER NAME
WARRANTY CLAIM REPORT
MONTH YEAR DLR. MONTH SERIAL
STAR HONDA INC
June 2019 TANK1

Product Line: Motorcycle Power Product Claim Type: Regular Extended Warranty
SERVICING DEALER CODE NO. SHIPMENT DATE MM - DD - YR MODEL NAME

304618 FROM HONDA July 2, 2019 CCG125WHJ-BK


SERVICING DEALER NAME AND ADDRESS PURCHASED MM - DD - YR MODEL CODE
DATE
STAR HONDA INC STOCK UNIT TMX125
MAHARLIKA HIWAY BRGY. LUMINGON,
MALFUNCTION MM - DD - YR FRAME NO.
TIAONG, QUEZON
DATE
TEL. NO. (042)785 5736 June 22, 2019 KSW10208406
CUSTOMER NAME AND ADDRESS MM - DD - YR ENGINE NO.
REPAIRED DATE
STOCK UNIT -STARHONDA TIAONG July 6, 2019 KSW10E210110
STARHONDA INC. DAYS DISTANCE
PERIOD
TEL. NO. LUMINGON, TIAONG, 0 KM
QUEZON
MC / PP MAIN USAGE AND EQUIPMENT DEFECT COLOR TECHNICAL REPORT NO. IF ATTACHED
DEFECT CODE
TRI & BLK
COLOR

DESCRIPTION OF CUSTOMER (SYMPTOM) ILLUSTRATION / SKETCH / PICTURE / DRAWING

STOCK UNIT/ RUSTYTANK SUB ASSY., FUEL

MECHANIC DIAGNOSIS AND COMPLETED REPAIR


STOCK UNIT/ RUSTYTANK SUB ASSY., FUEL

REPAIRED PART / REPLACED PART LABOR


PART DESCRIPTION PART NO. Q.TY PRICE FLAT RATE TIME
MAIN CAUSAL PART
1 TANK SUB ASSY., FUEL 17520-KSW-G10ZB 1 3,067.05 0.30

RELATED PART
2
3
4
5
6
7
8
9
10
11
12
REMARKS: MONTH DAY YEAR PARTS AMOUNT TOTAL FRT.
FILING DATE
June 22, 2019 3,067.05 0.30
Prepared by: LANDING COST ALLOWANCE LABOR RATE
Michael Andrew M. Panganiban Aristeo Geronimo 15% 595.31 150.00
NAME & SIGNATURE MECHANIC NAME & SIGNATURE TOTAL PART TOTAL LABOR COST
COST 3,662.36 45.00
PARTS AND LABOUR COST CURRENCY
STOCK UNIT -STARHONDA TIAONG JEANJANE CONCEPCION
DRIVER/CUSTOMER NAME & SIGNATURE BRANCH MANAGER NAME & SIGNATURE
3,707.36 PHP
( HONDA PHILIPPINES USE ONLY )
CHECKED BY:
APPROVED WRONG DATA
DISAPPROVED INCOMPLETE
REMARKS: Signature / Date
APPROVED BY:

Signature / Date

HPI-F-SVC-WTY-001 rev 2.0


MC / PP USAGE
DEALER CLAIMS DEALER SHIPMENT D. D'LER. DEALER CO NTACT CUSTOMER CONTACT PART NUMBER 1 Q'TY 1 CURRENT Q'TY Q'TY CURRENT Q'TY 4 CURRENT Q'TY 5 CURRENT Q'TY 6 CURRENT Q'TY 7 CURRENT Q'TY CURRENT Q'TY CURRENT RELATED PART Q'TY CURRENT Q'TY CURRENT Q'TY CURRENT
ENGINE NO. FRAME NO. M. NAME M. CODE DISTANCE PUR. DATE MAL. DATE REPAIR DATE DAYS COLOR DEALER NAME DEALER ADDRESS CUSTOMER NAME CUSTOMER ADDRESS (SOLO, TRI, BANGKA, DESCRIPTION OF CUSTOMER (SYMPTOM) MECHANIC DIAGNOSIS AND COMPLETED REPAIR MAIN PART FRT 1 RELATED PART 2 PART NUMBER 2 CURRENT SRP FRT 2 RELATED PART 3 PART NUMBER 3 FRT 3 RELATED PART 4 PART NUMBER 4 FRT 4 RELATED PART 5 PART NUMBER 5 FRT 5 RELATED PART 6 PART NUMBER 6 FRT 6 RELATED PART 7 PART NUMBER 7 FRT 7 RELATED PART 8 PART NUMBER 8 FRT 8 RELATED PART 9 PART NUMBER 9 FRT 9 PART NUMBER 10 FRT 10 RELATED PART 11 PART NUMBER 11 FRT 11 RELATED PART 12 PART NUMBER 12
NUMBER DISCOUNT DATE CODE CODE NUMBER NUMBER SRP 2 3 SRP SRP SRP SRP SRP 8 SRP 9 SRP 10 10 SRP 11 SRP 12 SRP
ETC)

CCG 125WH MAHARLIKA HIWAY BRGY. LUMINGON, STOCK UNIT


TANK1 31% TMX125 0 STOCK UNIT 6/22/2019 BLK BLACK 304618 STAR HONDA INC (042)785 5736 STARHONDA INC. LUMINGON, TIAONG, QUEZON TRI STOCK UNIT/ RUSTYTANK SUB ASSY., FUEL STOCK UNIT/ RUSTYTANK SUB ASSY., FUEL 1 4,445.00 0.3
KSW10E210110 KSW10208406 J-BK TIAONG, QUEZON -STARHONDA TIAONG TANK SUB ASSY., FUEL 17520-KSW-G10ZB
DRIVER BRANCH
MECHANIC DEALER
FRT 12 SELLING DEALER NAME MONTH YEAR /CUSTOMER'S MANAGER'S PREPARED BY FILING DATE
NAME DISCOUNT
NAME NAME
STO CK UNIT
STAR HONDA INC June 2019 -STARHONDA Aristeo Geronimo
JEANJANE CONCEPCION
Michael Andrew M. PanganibanJune 22, 2019 31%
TIAONG

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