TwoEXtend

Simplifying the complexities of delivering Extended Service Programs

Contact Us by Phone: 416-642-8478 or contact@twoextend.com

Submit a Claim

Last Name *

The last name of the individual registered for on the Extended Service Contract First Name *

The first name of the individual registered for on the Extended Service Contract Home Phone *

The phone number provided at the time the contract was purchased Address Street *

Your current address (does not need to be the one originally registered) Address Unit

Additional Adress Information Apt. or Unit or Suite, etc. City * Postal Code *

Include space for Canadian Postal Codes E-Mail *

E-Mail where we can send he status updates of your claim Store Name

The name of the store where the Extended Service Contract was Purchased Contract (Warranty) Number *

A unique 12 character identifier of the Extended Warranty Contract Contract Purchase Date Product Type *

Select the Product Type from the list. For OTHER enter a description of the product. Other Product Type

Enter a description of the product if you selected OTHER in the Product Type drop down. Brand Name * Serial Number *

Serial Number associated with the Product as Registered on the Contract Date of Purchase

Date you purchased the product (this maybe the same as the date you purchased the Extended Service Contract) Purchase Price Before Taxes *

The price that you paid for the product before taxes Problem Description Detail *

Describe (up to 200 characters) the problem the Product is experiencing. Problem Categorization *

Select all that apply to the Problem with the Product.Cracked or Damaged Lens/DisplayCracked or Damaged CaseWater DamageScreen Cloudy/FuzzyScreen Multiple Dead PixelsNo Picture/SoundDistorted SoundError Code FlashingWrong BIOS VersionMakes Loud NoisesSkipsOther Not Listed Here Repair Required *

Describe as best you can what you believe needs to be repaired. Type the following:

For security purposes, please type the letters in the image.