Koga Warranty

KOGA
WARRANTY & CLAIM FORM

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INVOICE NUMBER/ ITEM NUMBER*
STORE ITEM PURCHASED FROM*
UNIT MODEL*
DATE OF PURCHASE*
DD slash MM slash YYYY
DATE OF FAILURE
DD slash MM slash YYYY
CUSTOMER NAME*
First Last
CONTACT NUMBER*
EMAIL ADDRESS*
Enter Email Confirm Email
COPY OF TILL SLIP ATTACHED*
- Yes
- No
TILL SLIP IMAGE
Max. file size: 4 MB.
PICTURE OF COMPLETE UNIT*
Please upload a picture of your complete Koga unit
Drop files here or

Max. file size: 4 MB, Max. files: 3.
PICTURE OF PROBLEM AREA*
Please upload a picture of the problem area of your Koga unit
Drop files here or

Max. file size: 4 MB, Max. files: 3.
PART CAUSING FAILURE*
Please confirm which part is causing failure
NUMBER OF PARTS NEEDED*
BRIEF DESCRIPTION OF PROBLEM AREA*
Email
This field is for validation purposes and should be left unchanged.

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