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Customer Quality Request Form

This form is intended for Simport distributors for quality-related requests.
If you are an end user, please contact your distributor directly, as they have the information required for us to process your request. Thank you for your understanding.

* Indicates a required field

Distributor name or Company name

Simport Invoice Number

Phone number

PO Number

Item Number (Simport Product Code)

Lot Number(s)

Please provide all lot numbers related to this request.

Quantity affected per lot

Please provide the quantity affected for each lot listed.

Type of issue reported

Description of the reported issue

Please provide a clear, detailed and concise description of the reported issue. Specify when and how it was observed and indicate, if applicable, any recent changes to your equipment or procedures.

Photos of the product concerned and other relevant documentation

Please attach photos of the product concerned, as well as any other relevant documents or information related to your request. corresponding to each photo . A sample return may be required.

Example – Label Showing the Case Information

Example of the label showing the case information.

Upload a photo of the label showing the case information

Please upload a clear photo of the label ensuring that the case information is clearly visible.

Example – Eti-Lot Card

Example of the Eti-Lot card. Please ensure that the employee number is clearly visible.

Upload a photo of the Eti-Lot card

Please upload a clear photo of the Eti-Lot card, ensuring that the employee number is visible.

Example – PJ Label

Example of the PJ label to photograph.

Upload a photo of the PJ label

Please upload a clear photo of the PJ label, as shown in the example above.

Important: Please retain any product sample related to this complaint and do not discard it, whenever possible and safe to do so. A sample return may be required as part of our investigation.

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