Product Claim:
Inspection Details:
Date of Complaint
-
Day
-
Month
Year
Newflor Area Manager
Inspection Date
-
Day
-
Month
Year
Retailer Details:
Account Name and Location
Name of Claim Applicant (Person completing claim APP)
Store Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Unique ID
Product Code
Product Batch Number
Quantity Supplied (Lm)
Quantity Involved in Complaint (Lm)
Newflor Invoice Number
Date Supplied
-
Day
-
Month
Year
Retail Value of Installation
Additional Details
Problem & Details:
Complainant Name
Customer Contact Number
Please enter a valid phone number.
Complainant Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nature of Complaint
Location of Product in Building
Sub-floor (Specify Type)
Adhesive Used
Photos Supplied?
YES
NO
Sample Supplied?
YES
NO
Opinion as to Cause of Problem
Newflor Area Manager's Recommendations
Actions:
Credit Approved?
YES
NO
Credit Value
Credit Note Number
Credit Note Date
Product to be Returned?
YES
NO
Other:
Additional Information
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