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Customer Claim

Thermal Product - Customer Claim

Submit Claim Form

* Denotes required fields.

Special Instructions Based on the claim type indicated above, you must:

By clicking this box and submitting your claim, you agree to the special instructions above provided based on your claim type.*

Company Name:*  Contact Person:* 
Customer Reference No:*  Phone:* 
PO Number:*  Email:* 
Sales Representative:      

 Credit Dollars Requested ($): 

Description of Problem

Describe issue:*   
In what part of the process did the problem occur:*   

Material Amounts*

Material Type # of defective rolls Roll Width (inches) Roll Length (feet) Roll Tag #

Supporting Information



Product Name
Customer Part #

By submitting your claim, you agree to Ricoh Electronics, Inc.’s Terms & Conditions.

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