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Five Series Alfalfa
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Bayer Alfalfa
Product or Service Performance Issue (PSPI) Form
***For Internal Use Only***
Issue Type
Issue Type Options*
Incorrect Shipment
Seed Quality
Damaged Product (LTL Carrier)
Damaged Product (La Crosse Seed Truck)
Other
Check all that apply.
Who to notify*
Jeff Curran (Seed Quality)
Jacqueline Schwier, Matt Werth, Aaron Lukes (>$100 Damaged Prod- LTL Carrier)
Location Ops Leader (Incorrect Shipment)
(Cc DOO, Rep, VP of Sales & SSS on all issues)
Other Option
If "Other" checked above, put issue type here.
Final or Anticipated Credit Amount ($)*
La Crosse Seed Sales Manager*
Jenna Blue
Dave Braukmann
Jona Burrack
Richie Coleman
Jeff Curran
Bryan Decker
Bill Eatock
Greg Eaton
Al Halvorsen
Jay Hallenbeck
Joe Kelich
Brandon VanMiddendorp
Rob Vanscoy
Craig Wanzek
Tanner Wegscheid
Brad Weaver
Jeff Wienkes
Donna Wilson
Office Account
Doug Bastion
Ron Miller
Shipped From Location*
Ankeny
La Crosse
Lansing
Madison
Sioux Falls
Other
Sales Order (SO) Number*
Customer Information
Customer Company Name*
Customer No.*
Additional Information
Shipping Method*
La Crosse Seed Truck
LTL/Speedee/UPS (Specify Below)
Other (Specify Below)
Shipping Method - LTL or Other
PRO Number (LTL Only)
Product*
Lot Number
Purchase Date*
Total Affected Seed LBS.
Briefly Describe Issue*
Suggested Resolution*
File Upload
Upload pertinent material here.
File Upload
Upload pertinent material here.
File Upload
Upload pertinent material here.
File Upload
Upload pertinent material here.
File Upload
Upload pertinent material here.
Name of Person Completing Form*
