Extended Warranties

Extended Warranties
Name*

First NameLast Name
Company (If Applicable)

NameStore Location
Date*

DayMonthYear
Date
Email*
example@example.com
Contact Number*
Purchase Date *

DayMonthYear
Date
Date of Birth *

DayMonthYear
Purchased From *
Store Name or Vending Machine Location*
Product Name (Description) and SKU*
E.G, Wall Plug - ADPTCUSB
Purchase Price*
- If you purchased the product from a store or online please upload a copy of the receipt.

- If you purchased the product from a vending machine please take a picture of the packaging.
Take Photo
Take Photo
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Cancelof
Testapower

Phone: 1800 100 007

Email: admin@testapower.com.au

Web: www.testapower.com.au
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