Battery Warranty Registration Form

Please Fill Your Information Correctly

Name:	*
Phone:	*
Email:	*
Vehicle Model:	*
Vehicle Type A - Warranty terms:	-- Please Select you vehicle type -- Petrol vehicle for private use (12 months or 20,000 km) E-Hailing vehicle use (6 months or 20,000 km) Diesel for commercial use (6 months or 20,000 km) *
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:	Day 01020304050607080910111213141516171819202122232425262728293031 / Month January February March April May June July August September October November December / Year 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 *
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:
	Submit