Warranty Claim Form

Company Name

Product Number

Product Description

Purchase Date

Where was the product purchased from?

Order / Invoice No.

Location of the Faulty product

Fault Description

Was product installed by qualified electrician?

Additional information

Claim Preference

Claimant’s Name

Claimant’s contact number

Claimant’s email address

Attachments

Maximum 2 files.
20 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

CAPTCHA

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