Service Request Form
Customer Information
*
All Fields are Mandatory
(e.g. 1234567890)
(e.g. 123456 -> only numeric)
Product Detail
(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
Gear Box Serial Photo:
Application Photo Form 1–2-Meter Distance:
Complaint Reason Photo:
Supporting Photo: