All warranty claims must be filled within 15 days of machine failure date. All cells marked * are mandatory.
CONTACT INFORMATION
Account number
Last name
First name
Contact email
Phone
Company name
Address
City
State
Country
Postal code
PRODUCT INFORMATION
Serial number
Date of purchase:
Purchased from
INFORMATION ABOUT THE CLAIM
Type of claim:
Failure date
Hour meter reading
Repair date
DESCRIPTION OF THE FAILURE
Description of the failure, condition found, cause,…
If you already know the failed part, please enter the Haulotte reference in “Affected part number” and the traceability of the part in “Part serial number”.
CORRECTIVE ACTIONS TAKEN
Describe corrective action undertaken
Description of actions taken
INSERT IMAGES
Please click on “Browse” to upload each picture you want to attach to the form (plate, hour meter, general picture of the machine, detailed picture of the failure…).
Allowed extensions: png jpg jpeg (10Mb max per picture and 10 pictures max).
Pictures for the warranty form are mandatory to make a claim. This needs to be on there or claims can't be made
INSERT DOCUMENTS
Please click on “Browse” to upload each document you want to attach to the form. Allowed extensions: pdf docx doc xlsx xls pptx pptType of document: copy of the work order and/or mechanics report of the work done on the machine, copy of the part(s) invoiced if applicable (10Mb max per document and 10 documents max).
REPLACED PART(S) ON THE MACHINE
If a part needs to be returned, Haulotte will contact you.
LABOR AND TRAVEL EXPENSES
total number of hours worked
labor rate per hour
total labor
total number of travel hours
hourly travel rate
total travel
total freight cost
total miscellaneous cost
description of various costs
total cost claimed
ACKNOWLEDGEMENT
I, the undersigned, certify to the best of my knowledge that the above statements are true and correct, that the parts in question do belong to the equipment described, and the repair has been carried out, in a professional and workmanlike manner.
Your personal data will be kept for as long as necessary for the purposes pursued and will only be accessed to the extent necessary for those specific purposes.