Service Call Request New Zealand

Service Call Request New Zealand

PLEASE FILL IN ONE FORM PER PRODUCT.
To ensure prompt processing of your request, submit this form. For enquiries on a service call please contact our After Sales team on 0800 100 382.

Mandatory fields are indicated with an asterisk*.
Distributor Details
Distributor Name:
Date:
Store/Branch Location:
Phone Number

Area CodePhone Number
Contact Name:
Email address if you require confirmation of receipt
Customer Details: End user
Customer Name:

First NameLast Name
Site Address:

Street Address

Street Address Line 2

City

Postal / Zip Code
Email
example@example.com
Telephone (h):

Area CodePhone Number
Telephone (m):

Area CodePhone Number
Product Information
Part Number:
Part Number:
Quantity:
Product Type:
Proof of Purchase:

Original order number or invoice to customer
PO Number:
please provide a PO number, not an invoice number
Date Of Purchase:

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Is Product Installed:
Installation Date:

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Previously Inspected:
What is the issue or Fault:
***** ATTENTION CUSTOMER / END USER *****

*** PROOF OF PURCHASE MUST BE SUPPLIED ALONG WITH THIS SERVICE REQUEST FORM OR A SERVICE and/or REPLACEMENT WILL NOT BE APPROVED ***
Name Person paying if not warranty.
Kohler Co. allows up to 48 hours (two business days for Customer to be contacted from receipt of this service call. Note that forms entirely completed with photos of issue will be processed first.
Signiture
Please verify that you are human
Should be Empty:

Service Call Request New Zealand

Distributor Details

Customer Details: End user

Product Information

Proof of Purchase:

***** ATTENTION CUSTOMER / END USER *****

* ATTENTION CUSTOMER / END USER *