WARRANTY CLAIMS FORM

HEATING ELEMENTS

Purpose of this document:
The purpose of this form is to make the process of reporting a damaged or a defective heating element as straight forward and as easy as possible whilst still supplying us with as much applicable data as possible. It is imperative that you complete this form in as much detail as possible and submit any supporting data that you may have (photographs, engineers report etc.), it will not only assist us whilst we process and investigate your report it may in some cases help in the preliminary assessment of the probable cause of the problem.
The question and comments within this form are designed to allow us to understand the nature of the problem that you are reporting and are not in any case a verdict in the warranty claim procedure.
The final decision on any claim will be made after a full investigation and testing by the TERMA Claims Dept. our authorized representative.

* YOU ARE:

DISTRIBUTOR

CUSTOMER

* NAME:

YOUR REFERENCE NUMBER:

E-MAIL:

WHERE HAVE YOU BOUGHT
YOUR HEATING ELEMENT?:

YOUR COUNTRY:

DATES & TIME SCALES

* PRODUCTION DATE
(YYYY-MM-DD):

(It appears on the packaging or on the cover of the heating element operating instruction)

* DATE OF PURCHASE
(YYYY-MM-DD):

* INSTALLATION DATE
(YYYY-MM-DD):

(Or date of the first use, if different than the date of installation)

* DATE OF THE FIRST FAULT OCCURANCE
(YYYY-MM-DD):

The above information establishes:
1. Age of the device
2. Heating element operating time until the fault is observed
3. Shelf life length – length of time spent in distributor warehouse

HEATING ELEMENT (HE) IDENTIFICATION

Please mark answers by selecting the check box

* HE POWER OUTPUT
(This data can be found
on the rating plate on
the back of the controller or on a metal collar of the
heating element):

* HE POSITION:

HORIZONTAL

VERTICAL

RADIATOR IDENTIFICATION

Problems with heating element often are connected with radiator or the heating installation.

* Please provide as much information as possible - choose the method you prefer and then fill in the required information:

I know the manufacturer codes of the radiator (in this case we will need only some basic information about your heating installation)

I have a picture of the radiator (in this case we will need only the radiator dimensions)

none of above (in this case we will ask you to provide the radiator description by filling in a short questionnaire)

MANUFACTURER / MODEL / SIZE:

POWER OUTPUT[W] (1BTU/h=0,293W):

OPERATING CONDITIONS

RADIATOR CONNECTED TO THE CENTRAL HEATING (with HE placed directly in the collector pipe)

RADIATOR CONNECTED TO THE CENTRAL HEATING (with HE connected through a T-piece)

ELECTRIC RADIATOR (stand alone) with heating element installed by the user

ELECTRIC RADIATOR (stand alone) radiator bought with the HE already installed

RADIATOR DIMENSIONS: (height x width)

POWER OUTPUT[W] (1BTU/h=0,293W):

Your picture should show the whole radiator (towel rail), the way your heating element is installed and for dual fuel radiators the connection to the central heating installation.

RADIATOR DIMENSIONS: (height x width)

POWER OUTPUT[W] (1BTU/h=0,293W):

RADIATOR FINISH

CHROME

PAINT

TUBE PLACEMENT

VERTICAL

HORIZONTAL

NUMBER OF TUBES:

VERTICAL:

HORIZONTAL:

THE CLAIM CONCERNS:

(select most appropriate)

VISIBLE DAMAGE TO THE OUTSIDE OF THE DEVICE:

fractures

scratches

paint defects

none

Specify fault location: