Claim Form - eMobility • DEFA

Customer Information

End customer? Please do not use this form. Instead, submit your claim to the company where you purchased your DEFA product. This will help ensure the best and most efficient service.

Your role:

Country*

DEFA company the order was placed with*

Where did you buy the product?*

Company Name*

Organization number (VAT#)*

Company address*

Delivery address

Contact person*

Customer reference

Email*

Phone*

Product Information

Please provide as much information as possible – at least the item number, serial number, or sales order number.

Item number (product/article number)*

Serial number (unique number identifying the individual product)

Installation date

Sales order number (see order confirmation)

Issue Description

Describe the issue*

Please describe the issue in as much detail as possible: What happened and what did you observe? When does/did the issue occur – repeatedly or occasionally? Include any error messages (if relevant). If relevant, provide the vehicle model and model year. If you have already contacted DEFA Support, please include your support ticket number.

Attachment

Drop files here or

Accepted file types: jpg, jpeg, png, pdf, xls, xlsx, doc, docx, txt, rtf, odt, ods, Max. file size: 128 MB.

Attach relevant images and/or documents to support the issue description. If possible, please also attach your receipt.

Company bank details (IBAN / Account number)

Fill in if you request credit.

Claim form - eMobility

Customer Information

Product Information

Issue Description

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