Ab Närpes Trä & Metall
PB 68, FI-64201 NÄPES
CLAIM FORM
Deal / PA No.
SJS
Ref.
RMA Nr
Date
Applicant:
Name
*
Company
*
Address
City
Phone
*
E-mail
*
Country
*
-
AUT
CAN
DEU
DNK
EST
FIN
FRA
GBR
HRV
HUN
ISL
LTU
LVA
NLD
NOR
POL
RUS
SUI
SWE
USA
Customer:
Name
Company
Address
City
Phone
E-mail
Delivery date
Repair date
*
Equipment type
NTM
serial no
*
Operating hours / km
*
Details of failure and probable reason:
*
Part No
Description
Quantity
Price/unit
Price/total
Work
Hours
Labour costs/hr
Total
Parts total
Work total
Claim form status
accepted 
not approved
pending
Total
-
EUR
SEK
NOK
DKK
EEK
RUB
CAD
USD
*
Attach files (e.g. pictures)