Warranty Claim - Premier - MFG

By completing this form, you have requested your warranty claim be reviewed. If determined that that product failure has occurred within the applicable warranty period and is a result of a defect in materials or workmanship, a corrective action will be assigned and a Customer Service Representative will contact you regarding the warranty fulfillment process.
Name*
Email*
Phone*
Address*
City*
Country / Region
Please Select State/Province
Please Select State/Province
Province
Zip Code
Is ship-to address is different from above
- Yes
Address*
Name/Company Name Address City State / Province / Region ZIP / Postal Code
Phone Number*
Products Purchased
Distributor Purchased From:*
Approximate or Exact Date of Purchase*
MM slash DD slash YYYY
Detailed explanation of what caused the damage.*
Qty and Part Number or Description of damaged pieces.*
Qty. Part Number
Hidden
Upload Photo*
Max. file size: 128 MB.
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Accepted file types: jpg, png, jpeg, Max. file size: 30 MB.
Upload Invoice
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