*marked fields are mandatory

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Customer Support Form
Contact Name*   Contact Number*   Contact Email*  
Reporting Manager   Classifications*   Inquiry/Complaint Type:*  
Customer Name*   Customer Number*   Customer Email*  
Customer Type*   Customer Address*  
Complaint Description*  
Product Name*   Batch Number*   Qty Involved in PCS/LTR/KG  
Monthly Consumption in PCS/LTR/KG   Name and Location of Retailer/Distributor /Trader  
Invoice Number   Attachment    Attach files
Each of your file(s) can be up to 20MB in size.

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