Customer Claim - Sun Valley Rice

Customer Name/Branch*
Country*
Country
Contact Name*
Email*
Phone
Claim Details
Type of Claim*
Date problem was discovered:*
MM slash DD slash YYYY
If 'other' type of claim, please specify here:*
Name of person who discovered the problem:*
Method of shipping:*
Location where the problem was discovered:*
Sales order number*
Package name / Bag size:*
Rice Variety*
Product code date (ex: M.G.14121BSVR08:56:20):*
If other, please specify here:*
Quantity affected:*
Photos:
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Accepted file types: jpg, jpeg, gif, Max. file size: 16 MB.
Detailed Description
Claim Number
Email
This field is for validation purposes and should be left unchanged.

Claim Details