Guarantees and incidents form

1

CONTACT DETAILS

Name

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Email

email

Phone

Locality

Province

SPARE PART DATA

Spare Part

Brand

Model

Billing number

DATA OF THE FAILURE OR RETURN

Breakdown date

Reason

Choose an optionArrived brokenWrongly requested by the clientIt does not correspond to what I ordered

Full explanation of the breakdown or return

0 /

INSTALLER WORKSHOP DETAILS

Workshop name

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Workshop email

email

Workshop phone

Contact person

Full workshop address

Attach part assembly invoiceupload

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Attach pictures of the partupload

cloud_uploadSelect

I accept the privacy policy

Send

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