Product Claim Form
PRODUCT CLAIM
Inspection Details:
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Date of Complaint
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Newflor Area Manager
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Inspection Date
Retailer Details:
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Account Name
*
Customer Contact Number
*
Store Address
Product Details:
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Product Code
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Quantity Supplied (Lm)
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Quantity Involved in Complaint (Lm)
*
Newflor Invoice Number
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Date Supplied
*
Retail Value of Installation
Additional Details
Problem & Details:
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Complainant Name
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Complainant Address
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Nature of Complaint
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Location of Product in Building
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Sub-floor (Specify Type)
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Adhesive Used
*
Photos Supplied?
*
Sample Supplied?
*
Opinion as to Cause of Problem
*
Newflor Area Manager's Recommendations
Actions:
Credit Approved?
Credit Value
Credit Note Number
Credit Note Date
*
Product to be Returned?