Online Claim Submission
Online Claim Submission

Disclaimer: This form is only for US customers, if you experience any issues, please contact Billing@Rheem.com

Customer Type:

Customer Information:

First Name (required)

Last Name (required)

Company Name (required)

EIN (Employee Identification Number) (required)

Email (required)

Confirm Email (required)

Address Line 1 (required)

Address Line 2

City (required)

State (required)

Zip Code (required)

Phone

Cell

Fax

Unit Information:

Serial Number of failed unit (required)

Model Number (required)

WCN (required)

Product Type (required)

Date of Service was performed (required)

Service Technician Information

Company Name

Company Phone (enter only 10 digit number)

Representative Name

Description of work done

Reimbursement Information

Comments/Notes

Part Cost

Labor Cost

Additional Cost

Invoice Attachment (required)

Proof of Purchase

Proof of payment for labor

Current W9 (required)

Unit Label

Additional Attachment

In connection with your providing me with your personal information, we must advise you that information about Rheem’s practices regarding your personal information is located in Rheem's Privacy Notice located here.

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