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Sales warranty

1. Customer Particular

Name as per I.C

NRIC (New) Reg. No

Sex

MaleFemale

Tel No.(H)

Race

MalayChineseIndianOthers

Tel No.(O)

H/P No.

Email Address Preffered

Mailing Address

Postcode

2. Alternative Contact

Name as per I.C

H/P No.

Relationship

3. Alternative Contact

Referral Name

NRIC No

SW No

4. Product Details

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

Model:

Serial Number

Remarks

No.	Model	Serial Number
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5. General Information (for customer service)

Education:

Primary SchoolHigh schoolDiploma/DegreeMaster/PHD

6. Himmel VIP Info

VIP Name

VIP Code

H/P No.