Warranty Form - Bulthuis

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WARRANTY FORM
Recipient
Supplier:
:
Firma
Dinex A/S
Fynsvej 39
5500 MIDDELFART
DÄNEMARK
Date:
Recipient claim No.:
Contact person, e-mail:
Dinex No.:
Qty.:
Serial No.:
Delivery date:
Invoice No.+date:
Mounting date/km:
Dismantle date/km:
Vehicle manufacturer and type:
Chassis no.:
Manufacture date:
Engine-Type:
Capacity, cm3:
HP/KW:
Description of the claim:
Photo enclosed Yes 
No 
Filter and Retrofit issues:
Dinlog Data enclosed
Yes 
No 
Vehicle Reg. ID
EURO IV/V issues:
Increased noise level
Yes No  Engine lost power
Yes No 
Crack on overcoat/pipe/weld
Yes No  Vehicle run in safety mode
Yes No 
Check engine light ON
Yes No  Failure code enclosed
Yes No 
Another:
Packing mistakes:
Dinex No.:
Qty. invoiced:
Qty received:
*For succesfull claim treatment warranty form should be full filled and with all required attachment.
Dinex warranty form rev.5
1/1

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