Providing Premium Level Service for Your Appliances

Fill out and send the following form to request service on your appliance

Please make sure all fields marked *required are filled in correctly.

Surname or
Company Name

*required

Firstname or
Contact Person

Physical Address

Unit / Number
Street
Suburb
Email
*required
Contact Phone
*required
Mobile
Appliance Type
Brand
*required
Model Number
Serial Number
Purchase Date
Day Month Year
Purchased From
Date of Failure
Day Month Year
Authority No.
Nature of Fault
Urgent?
Please select only if you urgently require service on your appliance
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