Home
Contact Us
Please complete the request form below.
ONLY 1 unit per request
.
**All fields are required unless otherwise noted.
Dealer Info
(Exchange Unit will be shipped to this address)
Dealer Name:
Dealer Code:
Contact Name:
Address:
Address 2 (optional):
City:
State:
Zip:
Phone:
Format: xxx-xxx-xxxx
Fax (optional):
Format: xxx-xxx-xxxx
Email Address (optional):
Repair Unit and Customer Info
Repair Order # (R.O.):
Customer Name (optional):
Date of Service Request:
1
2
3
4
5
6
7
8
9
10
11
12
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2024
2023
2022
2021
2020
2019
Vehicle Model Year/Model (optional):
Mileage:
Warranty Start Date:
1
2
3
4
5
6
7
8
9
10
11
12
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2024
2023
2022
2021
2020
2019
VIN:
New Car Basic Warranty?
Yes
No
Unit Serial Number (if available):
Out of Warranty (Retail) Purchase?
Yes
No
Exchange for unsold car?
Yes
No
Description of Failure / Comments / SOA Technical Support Reference #:
**Only 1 item can be requested per form.
WARRANTY ITEM
RETAIL ITEM
UNSOLD ITEM
PART NUMBER
PART NAME
VEHICLE
MODEL YEAR
REMAN/NEW
RETAIL PRICE
86271AG04AR1
NAVI ASSY
LEGACY
06/07/08/09
REMANUFACTURED
N/A
86271FG010R1
NAVI ASSY
IMPREZA
08
REMANUFACTURED
N/A
86271SC010R1
NAVI ASSY
IMPREZA/FORESTER
08/09
REMANUFACTURED
N/A
86271SC111R1
NAVI ASSY
IMPREZA/FORESTER
10
REMANUFACTURED
N/A
86271SC500R1
NAVI ASSY
FORESTER
11
REMANUFACTURED
N/A
86271AJ60AR1
NAVI ASSY
LEGACY
10
REMANUFACTURED
N/A
86271XA00AR1
NAVI ASSY
TRIBECA
06/07/08/09
REMANUFACTURED
N/A
86281AG04AR1
DISPLAY ASSY
LEGACY
07
REMANUFACTURED
N/A
86281AG12AR1
DISPLAY ASSY
LEGACY
07/08/09
REMANUFACTURED
N/A
86281XA00AR1
DISPLAY ASSY
TRIBECA
06
REMANUFACTURED
N/A
86281XA05AR1
DISPLAY ASSY
TRIBECA
07
REMANUFACTURED
N/A
86281XA05BR1
DISPLAY ASSY
TRIBECA
07/08/09
REMANUFACTURED
N/A
86271AG04AS1
NAVI ASSY
LEGACY
06/07/08/09
NEW
$479.29
86271XA00AS1
NAVI ASSY
TRIBECA
06/07/08/09
NEW
$474.49
86271FG010S1
NAVI ASSY
IMPREZA
08
NEW
Order from SOA only
86271SC010S1
NAVI ASSY
IMPREZA/FORESTER
08/09
NEW
Order from SOA only
86281XA05BS1
DISPLAY ASSY
TRIBECA
06/07/08/09
NEW
$459.61
86281AG12AS1
DISPLAY ASSY
LEGACY
07/08/09
NEW
$477.81
86271SC111S1
NAVI ASSY
IMPREZA/FORESTER
10
NEW
Order from SOA only
86271AJ60AS1
NAVI ASSY
LEGACY
10
NEW
$1,212.51
86283AG23AS1
NAVI SOFT
LEGACY/TRIBECA
07/08/09
NEW
86283FG060S1
NAVI SOFT
IMPREZA/FORESTER
08/09/10
NEW
86283AJ03AS1
NAVI SOFT
LEGACY
10
NEW
86271XA00AS1
NAVI ASSY
TRIBECA
09
NEW
N/A
86281XA05BS1
DISPLAY ASSY
TRIBECA
09
NEW
N/A
86271SC010S1
NAVI ASSY
IMPREZA/FORESTER
09
NEW
N/A
86271SC111S1
NAVI ASSY
IMPREZA/FORESTER
10
NEW
N/A
86271AJ60AS1
NAVI ASSY
LEGACY
10
NEW
N/A
SHIPPING METHOD
PRICE
WARRANTY
2nd Day Air
$14.50
$0.00
Next Day Air
$26.00
$0.00
PRICE OF EXCHANGE PART(S) REQUESTED
to be calculated
SHIPPING (required if purchasing retail units)
$
2nd Day Air
Next Day Air
TOTAL RETAIL PRICE OF REQUEST
to be calculated
NOTES:
In-warranty DVD's may be requested only if original DVD is unable to be removed. There is no charge for a replacement DVD unless original is damaged.
Warranty does not cover customer abuse or damage.
No Trouble Found will result in an evaluation and remanufacture fee.
New parts may be ordered for In-Warranty replacement only if the vehicle has not been sold.
