29-31 Richland St. Kingsgrove. Sydney NSW 2208 Australia
Phone: 02 9554 9600 | Fax: 02 9554 9433
[email protected] | www.domuslighting.com
Service Request Form
DOMUS CEILING FANS WARRANTY REQUEST FORM
Please complete the following details for Domus to register for Warranty purposes.
DATE:
PRODUCT DETAILS
QTY
Product Name
Colour
Locations
Serial Number
Fault Description
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Purchase Details
Place of Purchase: _________________________________________________________________________
Date of Purchase: __________________________________________________________________________
Customer Details
Customer Name: __________________________________________________________________________
Address: _________________________________________________________________________________
Daytime phone number: __________________________________ Mobile: ___________________________
Email address: ____________________________________________________________________________
Installing Electrical Contractor Details
Electrician Name: __________________________________________________________________________
Electrical Contracting Company: ______________________________________________________________
License Number: __________________________________________________________________________
Installation Date: __________________________________________________________________________
