Battery Warranty Registration Form

Please Fill Your Information Correctly

Name: *
Phone: *
Email: *
Vehicle Model: *
Vehicle Type A - Warranty terms: *
Car Registration No.: *
ODO Meter/ Car Km : * (Picture) Must capture mileage at car

Battery Model: *(List you type and brand battery example :NS70 Yuasa)
Date of Purchase: / /
Seller Company/Name: *
Manufacturing Code: * (List number at you cover battery if have more than one)
(Please upload the picture of tab battery)

Please Upload Your Receipt: