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

        Email

          Product Information

          Product Name

          Serial Number

          Purchased Date

            Retailer

            Original Warranty Expiry Date

              Type of Extended Warranty

                • 1- Year extended warranty

                • 2- Year extended warranty

                • 3- Year extended warranty

                Coverage Start Date

                  Coverage End Date

                    Terms and Conditions

                    1. 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.

                    2. The extended warranty is valid from the expiry date of the original manufacturer's warranty.

                    3. The warranty does not cover damage caused by accidents, natural disasters, unauthorized repairs, or alterations to the product.

                    4. Claims must be submitted with a copy of the original purchase receipt and this completed warranty form.

                    5. 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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