A.B.N 28 319 856 563
A.C.N 107 006 268
DAMAGE CLAIM FORM
Time of Delivery
When you received the consignment, which of the following stickers were clearly
visible on the external packaging?
Fragile Top Loading Glass This Side Up
Reason for Claim
Please briefly outline the reason for your claim:
Please use one form per product claim.
In order to support your claim, may you please provide pictures of the damaged goods as they were
Do not dispatch the damaged product until requested by Technology Surveillance Group.
Please fax completed forms to 03-9802 9993 or mail to the following address:
P.O BOX 3115
WHEELERS HILL 3170