Hellenic Marine Feedback

Request for Help

Completing and sending this form will allow us to respond to your
need for help more quickly. Please give as much detail as possible.

Your name

Company

Address

City

State, Postal Code, Country

Phone

Fax

Email

Brief description of problem (example: fresh water pumps running but not producing sufficient pressure)

Please give a detailed description of the problem, including when the problem 1st occurred, what the equipment or system was doing before it failed, how the failure was detected and your best analysis of what caused the failure. You may write as much as you want.

Giving us the following information will allow us to more quickly find the parts needed to fix your problem(s).

Part One Make & Name (e.g., Man B&W Gasket)

Part One Part Number

Quantity / Other (volts, rpm, gpm)

+++++++++++++++++++++++++++

Part Two Make & Name

Part Two Part Number

Quantity / Other (volts, rpm, gpm)

+++++++++++++++++++++++++++

Part Three Make & Name

Part Three Part Number

Quantity / Other (volts, rpm, gpm)

Part Four Make & Name

Part Four Part Number

Quantity / Other (volts, rpm, gpm)

+++++++++++++++++++++++++++

Part Five Make & Name

Part Five Part Number

Quantity / Other (volts, rpm, gpm)

+++++++++++++++++++++++++++

Part Six Make & Name

Part Six Part Number

Quantity / Other (volts, rpm, gpm)

Thank you for your interest!

If you need additional space to list parts or give additional
information, please send via the following: