Warranty Claim Form

Please fill out each section in the Warranty Claim Application form with the required information to help expedite your claim status. Any missing information may cause delays or denial to your claim.

1. Consumer Name – Fill out all the consumer information. This is the person that used the tires on the road. We may use this information to contact them.
2. VIN – Fill out all the vehicle information. This is used to determine correct vehicle application and for mileage claims.
3. Fortune Distributor Name – Distributor information, typically PCTNA direct customer.
4. Fortune Retail Installer – Retailer or associate dealer that installed and removed the tires.
5. New Tire Size Installed – Fill out tire size and description. Why it was removed. Current retail selling price.
6. Mount and balance not included – you are responsible for the cost of any additional service charges, including mounting and balancing, alignment, disposal fees, or applicable taxes.
7. Type of Claim – Refer to claim legend for the applicable claim number code. DOT number off each tire listed in the claim form. Description of tire. Part number of tire. The BARCODE number (Labeled as Number 8) is typically located on the bead of the tire; each barcode is unique to every tire, and is necessary for all claims
   1. Photos are required to be submitted with each claim. Types of photos required:
      1. Photos of damage or defect if applicable. Please submit multiple angles if necessary to document issue.
      2. Photos of the DOT before and after being skived out.
      3. Photos of barcode for each tire.
      4. Photos of tread depth.
   2. Not all claims require skiving of DOT. In the event of the following circumstances, please note:
      1. In the event of a mislabeled or mis-shipped tire, please complete all steps of the claim process, however, do not skive the DOT number until instructed to do so by PCTNA. A PCTNA representative will review the claim and let you know how to proceed.
      2. In the event of a Uniformity or Out of round claim, please complete all steps of the claim process, however, do not skive the DOT number until instructed to do so by PCTNA. A PCTNA representative may be requested to retrieve the tires and subject them to further testing. Bar code serial numbers are necessary for out of round claims. Claims of this nature will not be accepted on more than 2 tires from the same vehicle. Dealers should be prepared to supply out of round data from their balancing machine if requested.