Warranty Claims

Please complete the following warranty claims form so we can assist you. You are required to have your proof of purchase as well as photos to assist us in resolving your claim.

Please Note: This form is for registering warranty claims for VAS product failures after installation or during use. If you require assistance with installing / using your product please refer to your fitting instructions or contact your dealer.

Personal Details
Name*
First Last
Phone*
Email*
State/ Territory*
Location*
Store Details
VAS Stockist/ Installer*
Company Details
Company
Address
City
State/ Territory
Postcode
Product Details
Part number*
Purchase date
Date Format: DD slash MM slash YYYY
Claim Details
Type of claim*
- Repair/ Replace
- Loss or Damage to property
- Refund
Were there any difficulties fitting this product?
Where did this incident occur?
When did the incident occur?
Date Format: DD slash MM slash YYYY
Please provide a detailed account of the incident*
Attach relevant images of your product
Drop files here or

Accepted file types: jpg, jpeg, png.
Supporting message*
Acknowledgement
Claim submitted by*
First
Certify Information*
I certify all information entered is true and correct to the best of my knowledge*

Warranty Claims

Personal Details

Store Details

Company Details

Product Details

Claim Details

Acknowledgement

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