Product Defect Claim Form

Allow me to share with you this Free Product Defect Claim Form in PDF Format as well as in text version to assist you quickly.

When a buyer discovers a defect or manufacturing problem in an order they have received, they have the legal right to inform the supplier and claim the warranty. This could involve requesting a refund, a replacement of the defective goods, or repair services. The formal communication to the supplier is done using a product defect claim form.

Importance of the Product Defect Claim Form

  1. Documenting Defects:
    • Provides a formal record of the defect and the buyer’s claim.
  2. Initiating Warranty Claims:
    • Allows the buyer to request a refund, replacement, or repair under the product’s warranty.
  3. Ensuring Accountability:
    • Holds the supplier accountable for the quality and performance of their products.

Key Elements to Include in the Product Defect Claim Form

  1. Addressing the Proper Person:
    • Identify and address the form to the supervisor or person in charge of warranty claims at the supplier’s company.
  2. Order References:
    • Include the reference number of the order and any related purchase order (PO) agreements.
  3. Important Dates:
    • Date of order placement, date of receiving the order, date of discovering the defect, date of writing the claim form, and the response deadline for the supplier.
  4. Description of Defects:
    • Clearly describe the defect(s) found in the product, including whether it is a manufacturing defect, design defect, or due to improper instructions.
  5. Warranty Details:
    • Specify the type of warranty provided with the product and what action you want to take (refund, replacement, or repair).
  6. Supporting Documents:
    • Attach necessary documents, such as the original PO, PO agreement, payment order, and the supplier’s warranty claim form.

Free Product Defect Claim Form {PDF Form}

Here is a preview of a Free Fillable Product Defect Claim Form created in PDF Format,

Product Defect Claim Form

Here is the download link for this Product Defect Claim Form,

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Sample Product Defect Claim Form

Here’s a sample template for a product defect claim form:

[Your Company Letterhead]

[Your Name]
[Your Position]
[Your Company Name]
[Your Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]

[Supplier’s Name]
[Supplier’s Company Name]
[Supplier’s Address]
[City, State, ZIP Code]

Dear [Supplier’s Name],

Subject: Product Defect Claim for Order [Order Number]

I hope this letter finds you well. I am writing to formally notify you of a defect in the product(s) received as part of our order [Order Number], placed on [Order Date].

Order Details:

  • Order Number: [Order Number]
  • Order Date: [Order Date]
  • Received Date: [Received Date]

Defect Details: Upon inspection and subsequent use of the product(s), we have identified the following defects:

  • Product Name/Model: [Product Name/Model]
  • Description of Defect: [Detailed Description of the Defect]
  • Nature of Defect: [Manufacturing Defect/Design Defect/Improper Instructions]

Warranty Details: Our purchase included a warranty that covers defects such as the ones described above. Given this, we request the following action:

  • Refund: [Amount or Details]
  • Replacement: [Details of Replacement Required]
  • Repair: [Details if Applicable]

Attached Documents:

  • Original Purchase Order (PO)
  • Signed PO Agreement
  • Payment Order
  • Warranty Claim Form Provided by Your Company

Please confirm receipt of this claim form and inform us of the steps you will take to resolve this issue. We expect a response by [Response Deadline Date].

Thank you for your prompt attention to this matter. Should you require any further information or clarification, please do not hesitate to contact me at [Your Contact Information].


[Your Name]
[Your Position]
[Your Signature]

By following these guidelines and using the sample template, you can effectively communicate your product defect claim to the supplier, ensuring that all necessary details are included and the process is documented professionally.


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