Claims form

COMPLETE YOUR CLAIMS FORM AND SUBMIT TO PRAIRIE HEATING PRODUCTS

Claims form

COMPLETE YOUR CLAIMS FORM AND SUBMIT TO PRAIRIE HEATING PRODUCTS

Customer Full Name: *

Company Name: *

Phone *

Email *

Reason for Claim *

Date Product Was Received: *

Product Claims

Item # 1

Shipment # Item Belonged In:

Reason for Claim *

Quantity Billed:

Quantity Received:

Quantity Damaged:

Quoted Price (If Pricing Claim):

Price Charged on Invoice (If Pricing Claim):

Item 1: Does this product need to be put back on order? *

Item 1: If this is a QC issue, what is the date on the box label or individual part label?

Please Submit Pictures for Damage Claims

Click or drag a file to this area to upload.

All Claims involving damages MUST have pictures included to be valid.

Item # 2

Shipment # Item Belonged In:

Reason for Claim

Quantity Billed:

Quantity Received:

Quantity Damaged:

Quoted Price (If Pricing Claim):

Price Charged on Invoice (If Pricing Claim):

Item 2: Does this product need to be put back on order? (copy) *

Item 2: If this is a QC issue, what is the date on the box label or individual part label?

Please Submit Pictures for Damage Claims

Click or drag a file to this area to upload.

All Claims involving damages MUST have pictures included to be valid.

Item # 3

Shipment # Item Belonged In:

Reason for Claim

Quantity Billed:

Quantity Received:

Quantity Damaged:

Quoted Price (If Pricing Claim):

Price Charged on Invoice (If Pricing Claim):

Item 3: Does this product need to be put back on order? (copy) (copy) *

Item 3: If this is a QC issue, what is the date on the box label or individual part label?

Please Submit Pictures for Damage Claims

Click or drag a file to this area to upload.

All Claims involving damages MUST have pictures included to be valid.

Comments

If no reason is supplied for the return, a 30% restocking fee will be automatically applied. All Claims must include pictures of the damaged product. All pricing claims must include original active quote and/or proof of pricing discrepancy. All shipping discrepancies must be claimed within 48 hours of delivery. All returned product is subject to a 30% restocking fee.

Date of Claim Submission: *

Signature *

Clear Signature

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Claims form

Claims form

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