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Electric Counterbalance Truck
Internal Combustion Counterbalance
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Truck Claim Form
Engine Type:
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Serial Number:
Truck Model:
Delivery Date:
*
Hour Meter:
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Branch/Dealer:
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Truck location:
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Report Date:
Normal Load Kg:
*
Reported By:
*
Site Conditions:
Hours used per Day:
*
Email address:
Temperature/Humidity:
*
Breakdown in detail description:
(If it is electric truck, please confirm to provide the error code )
*
Photo of working hours in meter:
Upload attachment
Only accept picture format, 3MB for each.
*
Truck nameplate photo:
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Only accept picture format, 3MB for each.
*
Customer’s suggestion and demand:
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Verification:
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