Service Request Form

Customer Information * All Fields are Mandatory Enter Customer Name Enter Contact Person (e.g. 1234567890) Enter Contact No Enter Email Enter Address Enter City (e.g. 123456 -> only numeric) Enter Pincode Enter District Enter State

Product Detail Sr. No (e.g. 15/123456, M123456, 999999) -Select- Gear Box Foot Damage Gear Box Adaptor Damages Gear Box H.S Ring Damages Gear Box Internal Gears failure Gear Box Heavy Noise Gear Box Bearing Noise Gear Box Excess Heating Gear Box leakages Gear Box output shaft key sheared Gear Box output shaft damage Ele Motor Current Issue Ele Motor Burnt Ele Motor casing damage Ele Motor Fan & Fan Cowl damage Ele Motor Fan Cowl damage Ele Motor Flange Damage Ele Motor Heating Problem Ele Motor Jam Ele Motor Noise Ele Motor Shaft Key Failure Ele Motor Shaft Play Ele Motor Tapping Ele Motor Terminal box Damage Ele Motor Tripping problem Dimension problem Hold back Wrong Supply Short Supply Any Other/add information in additonal information Select Nature Of Issue Gear Box Serial Photo: Upload Gear Box Application Photo Form 1–2-Meter Distance: Upload Application Photo Complaint Reason Photo: Upload Output Shaft Supporting Photo: Upload Complaint Reason