Warranty Claim Registration

Unique 5 Digit Number Generated*

Today's Date*

Dealer's Name*

Dealer's Address *

Customer Name*

Customer Address*

Email*

Contact No. *

Claim Description*

Type & Model of Machine*

Serial #*

Cause of Fault*

Date of Fault*

Date Machine Sold*

Description of Repairs Carried Out*

Date of Repair*

SlurryQuip parts supplied: Quantity/ SlurryQuip Part Reference/ Part Description/ Total Value/ SlurryQuip Invoice No.

Photo Before Claim*

Photo After Claim*

Is this machine warranty registered? Please note registration is a condition of warranty.* Is this machine warranty registered? Please note registration is a condition of warranty.* Yes No

I agree that the personal information provided above and other information about me that become known through the business relation is recorded by Slurryquip ltd and stored, processed and used by Slurryquip ltd for Warranty Puropses under S.285 of the Companies Act 2014 and S.886 of the Taxes Consolidation Act 1997. If you choose to refuse this consent, it will not affect the delivery of the machine purchased or the service provided by Abbey or the Sales Partner / Dealer in anyway. Please state your preference by ticking the appropriate box. You are free to revoke your consent in writing at any time with SlurryQuip Ltd, Clough, Downpatrick, County Down, Northern Ireland* I agree that the personal information provided above and other information about me that become known through the business relation is recorded by Slurryquip ltd and stored, processed and used by Slurryquip ltd for Warranty Puropses under S.285 of the Companies Act 2014 and S.886 of the Taxes Consolidation Act 1997. If you choose to refuse this consent, it will not affect the delivery of the machine purchased or the service provided by Abbey or the Sales Partner / Dealer in anyway. Please state your preference by ticking the appropriate box. You are free to revoke your consent in writing at any time with SlurryQuip Ltd, Clough, Downpatrick, County Down, Northern Ireland* I do accept I do not accept