
WARRANTY CLAIM FORM No.
Name of the dealer
Dealer stamp
Claim managed by
Date of purchase of the
machine
AGRISEM invoice number
Name and address of user customer
Date of delivery to user
(attach a copy of the invoice
and the dealer's delivery slip)
UAA of farm(s)
Machine serial number
Working width
Description of the equip
-
ment combination (make
and type)
Make of tractor used
Model of tractor used
Power rating
Detailed description and
alleged cause of the
incident
Date of breakdown
Current date
Part reference
Quantity
Description
Send parts requested
YES
Credit note requested
YES
Photographs attached
YES
Parts returned
Freight costs payable by the
sender
YES
Result of inspection by AGRISEM INTERNATIONAL
Comments
Date
Signature
Technical manager
AGRISEM INTERNATIONAL SA - 535 rue Pierre Levasseur - CS 60263 - 44158 ANCENIS - FRANCE
Tel.: +33(0)2.51.14.14.40 - Fax: +33 (0)2.40.96.32.36
Summary of Contents for 5 Series
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Page 122: ...User manual Maximulch Series 3 Series 5 Series 6 122 NOTT GB 708 A 06 12 2019 ...
Page 124: ...User manual Maximulch Series 3 Series 5 Series 6 Appendices 124 NOTT GB 708 A 06 12 2019 ...
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