Warranty Claim Form

Please complete all mandatory fields marked with “#”: in Section 1 and select submit button to email to researchanddevelopment@taipan.com.au

NOTE: All claims are subject to our trading Terms and Conditions found in our Product Catalogue or on our website www.taipan.com.au.

Section 1 – Customer/Branch Staff Member/Territory Manager to complete

Customer Details
Company Name: #	Contact Name: #
Contact Number: #	Fax:
Email: #	Date: #
Purchase Details
Taipan Invoice Number: #	Invoice Date: #
Warranty Claim Details
Product Number: #	Batch Number:
Machine Type/Model:
Pressure Rating of Circuit:
Oil Type in Use:
Actual Hose Tail Crimp Diameter:
Description of Failure: #

Section 2 – Research and Development Manager to complete

Date Notified:	Claim Number: WCF-
Contact Number:	Date WCF issued:
Date Assessed:	Issued By:
Assessed By:	Date Credit Processed:
Credit Processed By:	Credit Note Number:
Details of Outcome
Complete all Section 2 and save Warranty Form into Customers folder on X Drive