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Product return form

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Don’t forget to click on the button ‘’Submit form’’
Information:
Return type:
Preferred Action:
Customer information
Your company:
Contact:
E-Mail:
Address:
Tel: Your reference no.:
Fax: Your WIKA customer ID:
End customer:
Product return information
WIKA part no.: Quantity ordered:
Original WIKA sales order/ customer purchase order: Quantity faulty:
Country of origin (foreign trade legislation): Quantity returned:
Product type:
Additional product description (e.g. Customer Part Number):
Report on findings
Report type:
Problem description:
Checklist Applications:
Working pressure/temperature:
Vibrations/pulsations:
Environmental condition:
Time in service:
Statement of Non Hazardous Shipments

Used medium (This unit is contaminated with the following agent/chemical):
Hazard classification:
Action required
Documents for information (< 2048 kB)
Attachment 1
Attachment 2
Attachment 3