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HOME OWNER PRODUCT COMPLAINT / CLAIM FORM
Today's Date
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Month
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Day
Year
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Date of Loss
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Month
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Day
Year
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Contractor Company Name if Applicable
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Customer Name
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First Name
Last Name
Customer Location
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Customer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Customer Email
example@example.com
Product Information
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Part Number
Product Description / Name
Product Information Cont.
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Quantity
Lot Code
Are samples of the product(s) in question available for review? - Please maintain possession of the physical evidence, shipping information will be provided later.
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Are photos / videos available for review? - Photos / videos can be sent back with this form to technical@oatey.com
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Are detailed invoices / reports ready to be submitted? - Documents can be sent back with this form to technical@oatey.com
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Describe Incident / Product Concern
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Should be Empty: