WARRANTY REQUEST FORMPhone: (07) 3440 7600 Int: +617 3440 7600Phone: 1300 307 289Fax: (07) 3344 1000 Int: +617 3344 1000Email: service@stoddart.com.auTo ensure we can provide the best possible service we require you to complete this form. Make, model and serial number, along with other essentialinformation. To secure a call, you must also have an account with Stoddart or complete the credit card details below.THIS FORM MUST BE COMPLETED OR WARRANTY CANNOT BE PROCESSEDName of contact person on site: Date: / /Business/Organisation name:Street Address:Suburb: State: Post Code:Phone (Site): Mob:Equipment Type: Brand:Model/PNC no.: Serial no.:Location (large sites only): Open: Close:Date of purchase:Company purchased from:(please provide a copy of your tax invoice or delivery docket as proof of purchase)Description of fault:Has the following been checked (tick box if appropriate and checked)?Electrical power supply Gas Water SupplyName of person requesting warranty (please print):CREDIT CARD DETAILS – Required as security against chargeable work (see note below)Card type: Visa MastercardCardholder name: Card no.:Signature: Expiry Date:PLEASE NOTE: Warranty call-outs take place Mondays to Fridays between 8.00 and 16.30 (except public holidays). Any calls outside thesetimes will be subject to penalty rates. Certain items such as glass components and light fittings are not covered under warranty. Claims for non-covered parts, no faults found, travel over 50km or other items outside our standard terms and conditions will be chargeable. Any chargeableitems will be COD terms – payable onsite.CREDIT CARD INFORMATION MUST BE PROVIDED AS SECURITY AGAINST FALSE WARRANTY CALL-OUTS. FAILURE TO DO SOWILL RESULT IN REQUEST BEING UNATTENDED. NORMAL BUSINESS HOURS ARE 8AM – 4.30PM MONDAY TO FRIDAY