Consumer - Installation Warranty Form Date of Purchase(Required) MM slash DD slash YYYY Date of Install(Required) MM slash DD slash YYYY Consumer DetailsName(Required) Surname(Required) Mobile Number(Required) Email(Required) ID Number(Required) Vehicle InformationVehicle Make(Required) Vehicle Model(Required) Vehicle Year(Required) Vehicle VIN No.(Required) Authorized InstallerName Of Installer (Dealer Name)(Required) Customer SatisfactionPlease confirm your level of satisfaction for each below.Installation Quality(Required) Excellent Good Fair Bad Performance of Product(Required) Excellent Good Fair Bad Dealer Experience(Required) Excellent Good Fair Bad Dealer Courteousness(Required) Excellent Good Fair Bad It is important for us to know that you are happy with the Dealer you selected to complete the installation and the performance of your products installed. Please feel free to add your comments below. These comments will not be disclosed to the Dealer.Product Information and Proof of InstallationProduct Information(Required)Product NameSerial NumberQuantity Add RemovePlease use the plus button to add additonal columns for multiple products.Scan/Photo of Installation Invoice(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, maxfilesize:5mb, Max. file size: 512 MB. I hereby declare that the information provided is accurate and true.(Required) I Agree I Disagree NameThis field is for validation purposes and should be left unchanged.
