Warranty Claim Form

The Nomad Company B.V.
Stoomweg 13A

2631RR

Nootdorp, The Netherlands

support@nomad.nl

www.nomad.nl

+31(0) 306622423
Warranty Claim Form
1. Only one claim per submission will be processed.

2. Picture of the claim is mandatory for us to evaluate.

3. It is in our right to disapprove any cliam request that is found incorrect or fraud.
Purchase Information
Dealer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purchase Date

DayMonthYear
Date
Product ID
Describe the issue
Claim Picture

Cancelof
Customer Details
Customer Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: