If your equipment is still within the manufacturer’s warranty, please contact the company that supplied your equipment. If your equipment has extended warranty provided by us and is not within the manufacturer’s warranty, please complete the online claim form below.Your DetailsIndividual and/or organisation submitting the claimName*Your First and Last Name as registered to the Policy First Last Organisation (if applicable)The organisation as registered to the PolicyAddress*The address to which your Policy is registered Street Address Address Line 2 City Region Postcode Contact Number (9am-5pm)*Email*The e mail address to which your Policy is registered Warranty Number*The Unique Reference Number shown on your Policy ScheduleFault DetailsPlease note that if the device is less than 12 months old, then please contact your manufacturer. They will cover this period under their warranty. Date Fault Occured* Date Format: MM slash DD slash YYYY Fault Details*Please provide full detailsOther WarrantiesDo you have any other warranty that may cover this incident*YesNoPlease provide the warranty company and warranty number*Name, Address and Unique Reference NumberVAT StatusAre you VAT registered*YesNoPlease confirm your VAT number*Unique VAT Number as issued by HMRCDeclarationThe details you supply will be used to administer your claim and to combat fraud. The answers to the questions will be the basis of the assessment of your claim. All material facts must be disclosed. A material fact is one that is likely to influence us in the assessment or acceptance of this claim, or one that is likely to influence our consideration of cover under the terms of your policy. If you are in any doubt as to whether a fact is material, you must disclose it. I/We submit my/our claim for the amounts stated and declare that, to the best of my/our knowledge and belief, all information given on this form is true and correct, as will be my/our response to any further enquiries made by compuwarranty.Confirmation* Please tick the box to confirm you have read the declaration Details of ItemMake*Manufacturer e.g. AppleModel*Model number and type as listed on the appliance or in the manualColourThe colour of the applianceSerial Number*The Unique Model / Serial Number listed on the appliance or in the manualDate Purchased*Date the Item was purchased Date Format: DD slash MM slash YYYY Where Purchased*Retailer the item was purchased from and locationPurchase Price (inc. VAT)*The price you paid for the itemAdditional InformationIf you have any additional information that will assist us with your claim, please include details below:Declaration*I hereby certify that all the information given in this form is truthful, accurate and complete.CAPTCHA
