Contact data: Pflichtfeld Firm* Pflichtfeld Title* ---MsMr First name Pflichtfeld Last name* Pflichtfeld Phone-no.* Pflichtfeld e-mail* Order data: Pflichtfeld Delivery note no.* Your reference Material data: Pflichtfeld OMNILAB article no.* Pflichtfeld Article discription* Lot-/Serial-no. Pflichtfeld Qty. on delivery note* Pflichtfeld Qty received* Pflichtfeld Complained qty.* Pflichtfeld Issue* Wrong quantity delivered Wrong product delivered Goods damaged Packaging damaged (Transport damage)* Wrong product ordered / product does not fit** Quality not OK / Repair *The acknowledgement of the transport damage from the forwarding company or parcel service needs to be attached.** I confirm that the goods are in flawless, unchanged condition and in original, not opened, not laminated and not marked packaging. (Exceptions: Damaged goods / packaging, hidden faults or guarantee.) Pflichtfeld Your Request* Subsequent delivery Replacement Return the goods to OMNILAB for Credit Note Return the goods to OMNILAB without Credit Note Take over the goods at customer Guarantee Quotation Remarks Attach files You cann upload up to 5 files. Attachment 1 Upload another file Attachment 2 Upload another file Attachment 3 Upload another file Attachment 4 Upload another file Attachment 5 All statements are truthfully given by me. *Required We will answer your request immediately. Please be aware, that a return shipment is only possible with a Return Note, issued and signed by us. Notes on data protection: Any personal data provided by you may be used without your consent for handling your request.