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Internal Use Only:
Warranty Decision:
Customer Section:
Product Description:
Customer / Distributor:
Detailed description of problem/ fault (MANDATORY):
Insert pictures below:
Please be aware that we cannot accept field-failure reports that do not have mandatory sections
completed.
Customer Complaint / Fault Report
Source Area:
Part Number:
20-Digit Product Barcode Number (MANDATORY):
Page 7
Report No:
Date:
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