Pump Submission Form

Technical details
Please add a photo of the pump name plate or add the details manually.

Browse Files

Cancelof
Pump make
Pump model
Serial number (please state "unknown" if not known or not legible)*
Oil type*

MineralSynthetic (food safe)Semi syntheticUnknown

Customer declaration
Email address for quotation*

Same as contact email addressDifferent email address
Contact name for quotation*

First NameLast Name
Contact email for quotation*
example@example.com
Would you like Busch (UK) to contact you with alternative solutions such as Rental Pumps, Alternative Technology, Field Service, etc?*

Yes, please contact meNo, not this time
Would you like Busch to arrange collection of the equipment?*

Yes, pleaseNo, I'll arrange
Declaration:*

I declare that all the statements are correct and complete.
Signature*

Clear
Your unique reference number:
Please verify that you are human*
We use your data exclusively to answer your inquiry. By submitting my request, I agree to the processing of my data as described in detail in the data protection statement.
Should be Empty: