Customer name

Complaint ID

Billing address

Phone number

E-mail address

Product serial number*

YesNo

YesNo

YesNo

YesNo

Commissioning location (postcode, town, street, house number)

Commissioning date

Exact fault description

Attach a copy from the invoice, for devices under warranty (maximum file size: 3MB/image, PDF):

Attach filled warranty card (except for Plug&Play) (maximum file size: 3MB/image):

Signature

I have read and agree to the Privacy Policy
I consent to the collection and use of my personal information for marketing purposes
I accept the warranty regulations of Euro-Clear Ltd. If the fault is not of a warranty nature, I acknowledge and pay the repair and departure fees to the specialist service recommended by Euro-Clear Ltd.

Customer name

Complaint ID

Billing address

Phone number

E-mail address

Attach invoice (maximum file size: 3MB/image):*

Attach complaint record (maximum file size: 3MB/image):*

Exact fault description

Signature

I have read and agree to the Privacy Policy
I consent to the collection and use of my personal information for marketing purposes
I accept the warranty regulations of Euro-Clear Ltd. If the fault is not of a warranty nature, I acknowledge and pay the repair and departure fees to the specialist service recommended by Euro-Clear Ltd.