Dealer Service Form – Dealer Service Form

We are sorry to hear that a problem has arisen with your product or service. To ensure that we can help you as quickly and effectively as possible, you can use our service form. This form is intended for reporting problems such as product defects, damage resulting from services provided, missing parts, etc.

You must complete the form in as much detail as possible and attach photos of the problem so that we can get a clear picture of the situation. This way we can better assess the problem and offer a suitable solution.

If you have any questions, you can contact us by telephone. We can be reached on +31 (0)78 623 1234.

 

We are sorry to hear that there is an issue with your product or service. In order to help you as quickly and efficiently as possible, we have a service form that you can use to report problems such as product defects, damage caused by our services, missing parts, etc.

You are required to fill out the form in as much detail as possible and attach photos of the problem, so that we can get a clear picture of the situation. This way we can better assess the problem and provide a suitable solution.

If you have any questions, you can contact us by phone. You can reach us on +31 (0)78 623 1234.

Enter the date you submit the service request. Enter the date on which you submit the service request.
Enter the name of your company. Enter your company name here.
Enter the name of the contact person. Enter the name of the contact person.
The telephone number where we can reach you. The phone number where we can reach you.
The contact person's email address. The email address of the contact person.
Enter the order number or invoice number you received from us. Enter the order or invoice number you received from us.
Enter our item number that you will find on the order or invoice. Enter our item number that you can find on the order or invoice.
Provide a brief description of the item you are requesting service for. Provide a brief description of the item for which you are requesting service.
Provide a brief description of the problem for which you are requesting service. Provide a brief description of the issue for which you are requesting service.
Indicate which part you need for your item. Specify which part you need for your item.
Indicate how many copies of the required part you need. Specify how many units of the required part you need.
Was the item shipped to an address other than that of the dealer? If so, please complete the fields below. Is the item shipped to a different address than that of the dealer? If yes, please fill in the fields below.
Enter the name of the company at the delivery address. Enter the name of the company at the delivery address.
Enter the name of the contact person at the delivery address. Enter the name of the contact person at the delivery address.
Enter the address where the item was delivered. Enter the address where the item is delivered.
Enter the zip code of the delivery address. Enter the postal code of the delivery address.
Enter the place where the item was delivered. Enter the city where the item is delivered.
Enter the telephone number where the contact person can be reached for any questions. Enter the phone number the contact person can be reached for any questions.
Add any comments relevant to your service request. Add any comments that are relevant to your service reuqest.
Click or drag files to this area to upload. You can upload up to 10 files.
In order to carry out the service correctly, we always need a photo of the product/part. Without that photo we cannot properly process the service request. If it turns out on location that incorrect product information has been provided, costs may be charged afterwards. If in doubt, always contact our office staff first, available on telephone number +31 (0)78 623 1234 ••• In order to perform the service correctly, we always require a photo of the product/part. Without this photo, we cannot process the service request properly. If it turns out on location that incorrect product information has been provided, additional costs may be charged afterwards. In case of doubt, always contact our internal service department first, reachable at telephone number +31 (0)78 623 1234.
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