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FORMULAIRE DE DEMANDE D’INDEMNISATION D’ACTIFORCE
Actiforce Claim Form
Company Details
We kindly ask to fill all details about your claimed product below. The Claims Team will get back to you shortly.
Company Name
(Required)
Your Last Name
(Required)
Your First Name
(Required)
Your Email Address
(Required)
Email Address
Confirm Email Address
Your Own Reference Number
(Required)
Claim Type
(Required)
Return
Replacement
Service call
Other
Please describe claim type
Order Details
Sales Order Number
(Required)
Item Number
(Required)
You can find the number on the original order confirmation.
Product Description
(Required)
Quantity of Claimed Items
(Required)
Claim Category
(Required)
Product Quality
Wrong Product
Missing Part
Transport
Is the packaging damaged?
(Required)
**When YES, pictures are required
Yes
No
Description of the Quality Issue
(Required)
Photos / Video Upload
We require one close up of the defect and one full size photo of the product. A video is required if the damage can not be visualized on a photo. Furthermore for lighting products, a picture of the product label has to be attached. If quantity of claimed products is more than ONE we require a picture of EACH claimed product
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, Max. file size: 8 MB.
Return Details
Is the Claimed Product ready for Collection?
(Required)
Yes
No
Address
(Required)
E-Mail address
(Required)
Phone Number
(Required)
Contact Person
(Required)
Please confirm
Comments
This field is for validation purposes and should be left unchanged.
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