Shimano Bicycle Customer Warranty Form
Please fill out all the fields and click Submit
First Name:
Last Name:
Address:
City:
State:
--None--
AL
AK
AZ
AR
AS
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MH
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
AA
AE
AP
Postal Code:
Email:
Phone:
Item Number:
Size Length:
Month Purchased:
--Please Select--
1
2
3
4
5
6
7
8
9
10
11
12
Year Purchased:
--Please Select--
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Length Of Use:
--Please Select--
New
0 - 3 Months
4 - 6 Months
7 - 9 Months
10-12 Months
13-15 Months
16-18 Months
19-21 Months
22-24 Months
25-27 Months
28-30 Months
31-33 Months
34-36 Months
Bike Type:
--Please Select--
EBike
Kids Bike
Gravel Bike
Comfort Bike
Road Bike
Mountain Bike
Other
Return Product if Denied:
--Please Select--
Yes
No
Reason For Evaluation:
Please verify you're not a robot before clicking submit.