Warranty Claim Form
Approval No:
You will need the following:
Customer Details
Purchase Details
Installers Details
Please complete form below.
Once complete, please email this form and required documents to
• Proof of purchase
(Such as the original dated purchase receipt/invoice)
• Proof of Installation
(Certificate of Compliance)
First Name:
Last Name:
Address of Installation:
Address Line 2:
City:
State: Post Code:
Contact Number:
Mobile Number:
Email:
Signature:
First Name:
Last Name:
Installers Contact Number:
Electrical Contractors Licence Number:
Date of Installation:
Vencha Office Use Only:
Date:
Electrician:
Quote No:
Cost to Rectify:
Approved by:
Signed:
Product Name:
Product Code:
Quantity:
Description of Fault/Damage:
City:
State: Post Code:
Date of Purchase: Invoice Number:
Store Purchased From:
Содержание Raven
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