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Pattern of use: 1) stand-by for emergency, 2) routine use, 3) stand by, 4) other:
Environment: 1) Indoor, 2) Outdoor, 3) Heat, 4) Cold, 5) Humidity, 6) Sunlight, 7) Gases, 8) other:
Which
actions
have been
:
a) taken, b) planned by the reporter or user at the site of incident?
1) examination of the product on site, 2) replacement of the product, 3) other:
Suggested actions by the distributor/complainants
Returning of samples/faulty product(s),
1)
1) Already shipped/Will be shipped to ___________________________,
2)
2) Pending request from manufacturer,
3)
3) Product/parts not available:
Date:
We acknowledge the receipt of this report by manufacturer and will start processing it immediately. Please
use the assigned complaint report number for further reference.
Your contact person in this matter is:__________________________________________
Name:
Direct Tel.
Direct Fax.
Init/Date:
