Warranty form

Customer Details:


Title *

Initials *

Surname *

House number

Address *

Address 2 *

Town/City *

Postcode *

Telephone number *

Mobile 

Do you live in a newly built home under 12 months old?

Yes No

Are you the homeowner?

Yes No

Installer's details (if known)


Business name

Business gas safe no.

find

Installer's gas safe no.

Installer's name

Installer's email

Business house no

Business address

Address 2

Business town

Business postcode

Telephone *

Business region

Business Email *

Supplier's name

Product Details


Serial number is 14 numeric digits only.

Model

Serial no.

Installation date (dd/mm/yyyy)

Did you purchase a maintenance contract from your installer

Yes No

Expiry date (dd/mm/yyyy)


By submitting this registration form you are consenting to receiveing marketing
communications by post, phone, email and SMS unless you indicate an objection to receiving
such communications by ticking the following.

Post

Phone

Email

SMS

* Fields marked with an asterisk are compulsory