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Kindly provide all the required information to ensure your claim is processed promptly and efficiently.

Full Name *

Company Name *

Address *

City *

Postal Code *

Phone Number *

Email Address *

Invoice Number *

Date of Invoice *

Product Name/ Description *

Product Code *

Quantity Affected (M2/Units). Specify measure unit used under Description of the issue *

Location of the Product: Address *

Location of the Product: City *

Location of the Product: Postal Code *

Description of the issue: (Please provide a detailed description of the problem or defect. Attach additional sheets if necessary.)

Date When the Issue Was First Noticed *

Supporting Documentation (front, back, serial number, any other pictures reflecting the issue) *

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Not Available (Please explain)

Additional Comments (If you have any additional comments or information that may help us resolve your claim, please provide it below.) *

Helpdesk Team

Declaration: I hereby declare that the information provided in this claim form is accurate and complete to the best of my knowledge. *

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