Customer Concern Form
1. Your Details
DEALER NAME
*
EMAIL
example@example.com
TEL.
CUSTOMER NUMBER
You find the Customer Number in the heading of the invoice.
COUNTRY
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
DATE
/
Day
/
Month
Year
REGIONAL SALES MANAGER
2. Product Details
PART NUMBER
*
INVOICE NUMBER
*
Example: 23-VE000000
PART DESCRIPTION
ORDER NUMBER
Example: C23-0001234
HOW MANY PRODUCTS HAVE QUALITY ISSUES?
*
HAS THE PRODUCT BEEN USED?
*
Yes
No
OF TOTAL QUANTITY DELIVERED/INSTALLED
Please, add the Serial Number
The Serial Number is the 9-digit code under the barcode as the following image shows:
Please, add a picture of the label
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3. Description of Concern
DESCRIBE YOUR CONCERN
*
A. RETURN OF UNUSED PRODUCT
B. WRONG PART DELIVERED
C. WRONG QUANTITY DELIVERED
D. DEFECTIVE PRODUCT
E. DAMAGED PRODUCT
F. INCORRECT PAPERWORK
G. PACKAGING ISSUES
Please, add a picture of label & packaging
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PLEASE ENTER MORE DETAILS HERE
*
4. Pictures/Videos are needed if concern B, C, D or E is selected at point 3 above
(In any case of a product quality failure please add several pictures of the product itself where the issue is visible and also several pictures of the environment where the product was installed picture of the full cluster, the milking place, the wash trays, the parking brackets and parking position of the cluster, etc.) – the more precise first-hand information we receive, the easier it will be to follow up.
UPLOAD YOUR PICTURES/VIDEOS HERE
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LASER CODE
For liner and tubing ranges only.
Additional quality questions
(Only for used defective products)
NUMBER OF MILKING COWS
NUMBER OF POINTS
NUMBER OF MILKINGS PER DAY
DATE PRODUCT WAS INSTALLED ON FARM
*
/
Day
/
Month
Year
5. Request
CREDIT TO ACCOUNT
SEND REPLACEMENT
DELIVERY ADDRESS (IF DIFFERENT TO INVOICING ADDRESS)
Final action will be confirmed after having
carried out our internal control
6. Returns
Please wait for the confirmation from your customer service representative before any effective return. They will inform in advance of any inspection cost and send official authorization as well as proper return address.
WILL ANY PARTS BE RETURNED?
*
YES
NO
IF YES, HOW MANY PARTS ARE RETURNED?
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