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  • Claim Application Form

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    javier cartagena
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    This document is a claim application under warranty for a Sakai product. It collects information about the customer, distributor, machine model and serial number, date of failure, and hours/kilometers of use. There is a section to describe the complaint, defect, analysis, and correction. The form tracks expenses for parts, labor, mileage, and others. It is submitted to Sakai for claim judgment and approval, with notes that accurate information and photos are required to improve products.

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    CLAIM APPLICATION FORM

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    This document is a claim application under warranty for a Sakai product. It collects information about the customer, distributor, machine model and serial number, date of failure, and hours/kilometers of use. There is a section to describe the complaint, defect, analysis, and correction. The form tracks expenses for parts, labor, mileage, and others. It is submitted to Sakai for claim judgment and approval, with notes that accurate information and photos are required to improve products.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    12 views2 pages

    Claim Application Form

    Uploaded by

    javier cartagena
    This document is a claim application under warranty for a Sakai product. It collects information about the customer, distributor, machine model and serial number, date of failure, and hours/kilometers of use. There is a section to describe the complaint, defect, analysis, and correction. The form tracks expenses for parts, labor, mileage, and others. It is submitted to Sakai for claim judgment and approval, with notes that accurate information and photos are required to improve products.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    　 CLAIM APPLICATION UNDER WARRANTY

    For　SAKAI　use　only

    Name　of　country Claim　number Date

    Distributor name Address

    Customer name Address

    Delivery date Model Serial No. of machine

    Date of failure Engine model Engine serial No.

    Hours Kilometers Date of service Date of completion

    FAILURE INFORMATION
    1. Complaint 2.Defect 3. Analysis 4. Correction

    By
    Distributor's representative

    SAKAI

    CLAIM　JUDGMENT
    Approved Not approved ※Please refer to the claim adjustment sheet for the Not approved.

    EXPENSES
    Part No. Part name Q'ty Unit price Amount
    0
    0
    0
    0
    0
    0
    0
    Sub ｔｏｔａｌ（A）

    Q'ty Unit price Amount


    Labor 0
    Mileage 0 1
    Outwork 0 2
    Others 0 3

    Sub total　（B） NOTE: This application is a valuable information


    Total (A)+(B) to improve SAKAI products.
    Date Adjusted Clear and accurate information is required.
    Accepted by ※Photos are required to be attached.

    QS-NW-08(01)

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