Free Extended Warranty Form Template
Extended Warranty Form
Please fill out the form below to apply for your extended warranty.
Customer Information
Name
Address
Phone number
Product Information
Product Name
Serial Number
Purchased Date
Retailer
Original Warranty Expiry Date
Type of Extended Warranty
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1- Year extended warranty
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2- Year extended warranty
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3- Year extended warranty
Coverage Start Date
Coverage End Date
Terms and Conditions
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This extended warranty covers the repair or replacement of the product in the event of manufacturing defects, mechanical failures, or performance issues not caused by external factors, misuse, or negligence.
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The extended warranty is valid from the expiry date of the original manufacturer's warranty.
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The warranty does not cover damage caused by accidents, natural disasters, unauthorized repairs, or alterations to the product.
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Claims must be submitted with a copy of the original purchase receipt and this completed warranty form.
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The warranty is non-transferable and applies only to the original purchaser.
Customer Acknowledgment
By signing this form, I acknowledge that I have read and understand the terms and conditions of the extended warranty.
Name:
Date:
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