Warranty claim application -SaMASZ

ZIP code*

Place*

Adress*

E-mail*

Phone number*

Data of the damaged machine and description of the fault:

Model*

Serial number*

Year of production*

Date of purchase*

The time of product use*

The number of worked hours*

ha/mth*

The type of tractor / vehicle with which the machine is aggregated*

Attachment 1

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* I agree, in accordance with the Personal Data Protection Act, to the processing of my personal data contained in the above form and the files attached to it for the purposes of processing the complaint by SaMASZ Sp. z o.o. I have the right to access and correct my data.

* – mandatory field