Bisque Claim Form
Please fill out the attached form so that we can quickly issue you a credit for your broken or defective bisque items you received. This form has a limit of 8 items. If you have more than 8 items, please submit another claim with those items on it.
Business Name
*
Customer number
*
Email Address
*
example@example.com
Full Name
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date Submitted
-
Month
-
Day
Year
Date
Claims
Invoice # (item #1)
*
Invoice Date (item #1)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #1)
*
Reason for claim (item #1)
*
Please Select
Broken
Defective
How many pieces are in this case (item #1)
Price paid per case (item #1)
*
How many pieces are you claiming (item #1)
*
Credit Value (item #1)
Upload photos of the broken or defective (Item #1)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #1?
Yes
No
Invoice # (Item #2)
Invoice Date (Item #2)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #2)
*
Reason for claim (Item #2)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #2)
*
Price paid per case (Item #2)
*
How many pieces are you claiming (Item #2)
*
Credit Value (Item #2)
Upload photos of broken or defective (Item #2)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #2?
Yes
No
Invoice # (Item #3)
Invoice Date (Item #3)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #3)
*
Reason for claim (Item #3)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #3)
Price paid per case (Item #3)
*
How many pieces are you claiming (Item #3)
*
Credit Value (Item #3)
Upload photos of broken or defective (Item #3)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #3?
Yes
No
Invoice # (Item #4)
Invoice Date (Item #4)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #4)
*
Reason for claim (Item #4)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #4)
Price paid per case (Item #4)
*
How many pieces are you claiming (Item #4)
*
Credit Value (Item #4)
Upload photos of broken or defective (Item #4)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #4?
Yes
No
Invoice # (Item #5)
Invoice Date (Item #5)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #5)
*
Reason for claim (Item #5)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #5)
Price paid per case (Item #5)
*
How many pieces are you claiming (Item #5)
*
Credit Value (Item #5)
Upload photos of broken or defective (Item #5)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #5?
Yes
No
Invoice # (Item #6)
Invoice Date (Item #6)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #6)
*
Reason for claim (Item #6)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #6)
Price paid per case (Item #6)
*
How many pieces are you claiming (Item #6)
*
Credit Value (Item #6)
Upload photos of broken or defective (Item #6)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #6?
Yes
No
Invoice # (Item #7)
Invoice Date (Item #7)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #7)
*
Reason for claim (Item #7)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #7)
Price paid per case (Item #7)
*
How many pieces are you claiming (Item #7)
*
Credit Value (Item #7)
Upload photos of broken or defective (Item #7)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #7?
Yes
No
Invoice # (Item #8)
Invoice Date (Item #8)
*
-
Month
-
Day
Year
Date
Item Sku # (Item #8)
*
Reason for claim (Item #8)
*
Please Select
Broken
Defective
How many pieces are in this case (Item #8)
Price paid per case (Item #8)
*
How many pieces are you claiming (Item #8)
*
Credit Value (Item #8)
Upload photos of broken or defective (Item #8)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Add another item after Item #8?
Yes
No
Total Claim Amount
Submit Claim
Should be Empty: