Warranty Form

Your information in this Warranty Form is important. This can be completed online (greater convenience, uploaded & stored digitally) or downloaded as a PDF, printed off, filled out and mailed to us. Whichever you prefer, please complete it so that you have all the required prerequisits in the event of a claim.

Insured Warranty Form

Purchaser Details

This is for the Insured Party

Mr, Mrs, Ms, Dr, Prof, Hon, etc

Kind of self-explanatory, right?

Surname of the insured party

This is be required for insurance

Preferred daytime contact number

If a company, enter fax (if you use one)

The cell number of the insured party

Preferably a personal email address


Your Product & Protected Items

Let us know about the item you have purchased and what it will be protecting!

This is the product code of the device you just purchased

What product did you purchase?

Look on the back of the product label

The Africa Surge Protector will be utilized on the following equipment belonging to the Purchaser (refer to clause 3.2.2 of the Warranty Agreement): (NB. The number of items listed below directly equates to the number of electrical outlets available on the Africa Surge Protector.

Example: LG 55" LCD TV

The serial No. of the LG 55" LCD TV

What would it cost to replace this item?


Address Details

Provide the address details of where the Surge Protector will be utilized and the users postal address

Physical Address

Where the Surge Protector will be used

House/Unit Number

Street, road or avenue name

Suburb or area

Major city name

A 4 digit area or postal code

Such as Gauteng, Western Cape ...

Postal Address

Where correspondence with the buyer is sent

PO Box or house/unit number

Suburb or Street, road or avenue name

Suburb or area

The major city

A 4 digit area code

Such as Gauteng, Northern Province, ...


File Attachments

Please attach these four files - they will be sent to us as attachments

KINDLY UPLOAD/ATTACH A COPY OF YOUR PURCHASE RECEIPT / INVOICE FOR THE AFRICA SURGE PROTECTOR HERETO.

I, the undersigned Purchaser, have read and understood the contents of the Warranty Agreement (“Agreement”) on the reverse side hereof in particular Clause 5.1. I have also completed the Equipment Warranty Form in full. My signature on the attached Warranty Form declares that I agree to be bound by, and abide by, and accept in its entirety, the contents of this Agreement.
Kindly Attach a signed copy of the Warranty Card that came with your product.

All files allowed. Scan the document to an image. Send as jpg or PDF. Maximum size 3MB.

All files allowed. Scan the document to an image. Send as jpg or PDF. Maximum size 3MB.

All files allowed. Scan the document to an image. Send as jpg or PDF. Maximum size 3MB.

All files allowed. Scan the document to an image. Send as jpg or PDF. Maximum size 3MB.



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