All Fields Required
Order Information
Contact Information
Customer ID#/Company _____________________________
Customer Contact Name _____________________________
Purchase Order # __________________________________
Phone ___________________________________________
Green Bay Packaging Item # _________________________
Email ____________________________________________
Check One:
Customer Reference # ______________________________
____ Evaluation Only ($0 claim)
____ Information Only (feedback)
Credit Dollars Requested ____________________________
____ Liability Claim
Corrective Action Letter Needed? ____N ____Y (If Yes, Roll Tag #’s Must Be Provided Below)
MRA Required? ____N ____Y
Description of Problem
(Example: laminate wrinkles, near the core, 200’ involved)
What is the issue?
When did it first occur?
In what part of your process are you experiencing the issue?
Please Attach Converted and Unconverted Samples To This Form Showing the Defect (width by 5-10 feet)
Material Amounts
(Material Quality Issues Only)
# of Defective Rolls
Roll Width
Defective Footage (FT)
Roll Tag #
Attach Roll Tags Here
Billing or Material Claims
(Material Quality Issues Only)
(No Testing Required)
Billing issues and other claims that do not require
material samples, or can be captured in a photo:
SHIP Completed Form and Samples UPS Collect - Account # 576-735
To: Quality Manager, 3250 S. Ridge Rd., Green Bay, WI 54304
Roll Width Discrepancy: Photo of roll with ruler
showing actual roll width and tag.
Telescoped Rolls
Crushed Cores
Transit Damage: Must be submitted within 5 days
of receipt of the shipment. Copy of the freight bill
with notation of damage and photo of damaged
goods required.
Email completed form and supporting documents to:
[email protected] or fax to: 920-338-7022 or