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Customer Submission Form
Please provide the details of the warranty claim
Name
First Name
Last Name
Main Contact E-mail
*
CC:
example@example.com
Airport
*
Company
Mallaghan Serial Number
*
Mallaghan Machine Serial Number
Add Additional Serial Numbers
Machine Hours
Enter all serial numbers followed by a comma.
Describe the problem
0/250
Upload photo if necessary
Upload a File
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of
Preferred Mallaghan Representative
*
Gareth Loughran
Ian Clernon
Simon Swift
Steven Fearon
Pearse Mckenna
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Warranty Record Type
Should be Empty: