Report a Company

You do not need to be a Member or pay a fee to file a complaint against a company to ERAI. Information you provide to ERAI is held in strict confidence; your identity is not released to parties not directly related to the incident. Upon filing this complaint you will be asked to provide adequate documentation to substantiate your complaint that may include Purchase Orders, invoices, email communications, failure reports, photographs, etc. For additional information, please review the ERAI Company Reporting Guidelines and ERAI's complete terms and conditions.

If you have any questions or have difficulty submitting this form, please contact the ERAI office at 239-261-6268.

Your Company Information



Reported Company Information

Incident Information

(if known)
Please describe any relevant details of this incident

Reported Losses

please describe if other
if other fees exist, please describe

Parts

Part Number(s) (please enter all part numbers and corresponding manufacturer name of parts involved in this incident):
Part Number Date Code Lot Code Country of Origin Mfg Qty UNIT PRICE


Please note that part number information is not required for past due invoice(s) or NSF check complaints.

Images/Files

Please use the file upload feature below to upload files and images. Select up-to 20 Images/Files:
jpg, gif, png, bmp, pdf, doc, docx, txt, rtf, xls, xlsx, ppt, pptx, zip


Review and Submit

Please review the details of your reported incident submission below. If any changes are necessary, you can use the previous button at the bottom of the page to go back and make edits. If you are done entering your part details, please complete the Captcha validation below and click on the Next button.
Your Company Information
Company Name
Company Contact
Email
Phone
Fax
Reported Company Information
Company Name
AKA/FKA
Company Type
Address 1
Address 2
City
State
Zip
Country
Phone
Fax
Website
Contact Name
Title
Email
Phone
Incident Information
Date of Incident
Type of Incident
Incident Description
Reported Losses
Terms
Currency
Cost of Goods
Shipping
Escrow Fees
Rework Charges
Testing Fees
Bank Charges
Legal Fees
Other Fees
Please describe
Parts
Images/Files
Important

Thank you for reporting data to ERAI.

An ERAI representative will process your report as quickly as possible. The part data has been uploaded to the ERAI internal operations database for vetting purposes. If you have any further questions, please call the ERAI office at 239-261-6268.

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  1. Introduction
  2. Reported Co. Info
  3. Incident Information
  4. Reported Losses
  5. Parts
  6. Images/Files
  7. Review and Submit