Canon Customer Repair Returns Form
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1Customer Repair Returns Form
Before you send your unit into one of the Canon Authorised Service Facilities (ASF), Please
complete this form in capitals and send it together with your product. The details will enable
us to process your repair as quickly as possible.
Fields marked with a * are mandatory
Customer Name/Address details
Return address details if different
* Full Name
Full Name
* Address
Address
* City/Province
City/Province
* Post/Zip code
Post/Zip code
* Country
Country
Helpdesk Sevice Request number (if applicable)
* Preferred telephone number
Preferred telephone number
Alternative telephone number
Alternative telephone number
E-Mail address
E-Mail address
CPS membership No, if applicable
CPS membership no if applicable
B.T.W. no / V.A.T. no/ Fiscal no., if applicable
B.T.W. no / V.A.T. no/Fiscal no if applicable
Product Information
* Model name/number
Serial number of main unit
(Please use an additional form for any additional products)
(Please use another form for additional products)
* Fault Description
(Please note any error codes or software/operating systems currently displayed/used.)
Accessories:
(Please do not include any accessories with your unit including batteries, memory cards, leads, manuals,
etc unless believed to be connected to the possible fault. If you feel it’s related to the fault please include
Prints/photos). For printers & multi-functional units please secure print head/inks tanks following the transport
instructions in your user manuals.
Please list accessories included (if applicable):
PHOTOCOPY of your valid proof of purchase included: YES NO
Please ensure that the product is packed with sufficient protection to prevent damage during transit
Thank you for taking the time to complete this form, please make a copy for your records
NB Canon is committed to protecting your privacy and any personal information supplied by you will be used by Canon solely for the
purpose of handling the repair of your Canon product. Your personal data is held on secure computer and manual files and shall not be
processed for any other purposes. For further details on Canon’s Privacy Policy, please visit the website
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Parent category: Business