Please complete the Tire Adjustment Request form below.

Please be sure to fill in every field. Thanks!

Please allow up to 30 days for your tire to be adjusted/replaced. The process involves us getting the tire from you, shipping it to the manufacturer, and then waiting on them to approve or deny the adjustment request. We apologize for the amount of time it takes. To speed up the process, you can call your manufacturer's consumer help line to get an authorization code.

Dealer Name: Dealer Address: Dealer City/State/Zip: Customer Number: Original Invoice Number: Customer Name: Customer Address: Customer City/State/Zip: Tire Size: Tire Brand: Tire Model: Serial Number: Tread Remaing: Year/Make/Model of Vehicle: Mileage Received: Reason for Adjustment Request: I hereby certify the statements of facts herein to be correct and further certify that the only claim arising from the used merchandise described in this claim form is for replacement of the used merchandise and that no personal injuries, property damage or other loss is involved: