Warranty Claim

1 Year Warranty Claim **Please Note, ONLY compatible with Google Chrome

ALL required inputs below can be found on Valve White Label or Auxiliary Tag

*NOTE: For Domestic Customers, Valve MUST be returned to Durbin within 15 days. For International Customers, Valve MUST be returned to Durbin within 45 days. Failure to return valve by these times will result in voiding of warranty

Basic Information

Contact Name

Company Name

Address

Date

Phone

Email

Contact Preference
PhoneEmail

Type of Goods
Pneumatic (Model Number does not begin with SYN)Synergy (Model Numbers begin - SYN)Other

Has this product been disassembled at the plant?
**Synergy Valves are required to be returned as a complete unit
NoYes

Job Number

Original Product Ship Date (Not customer return date.)

Barcode # (If applicable. If not, place 0)

Durbin Part #

Technical Information

Temperature (deg F)

Pressure (psig)

Reason removed from service

Fluid type/media (e.g., water, steam, nitrogen)

*Other notes customer would like to add

Warranty Requirements

All the requirements must be met to be considered for warranty:

Form must be included with your ValveValve must be placed in a separate box to eliminate confusion on which valve the request is forBox must be clearly labelled with your claim number you received after submission

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