Warranty extension

Applicant

Company*

Surname*

First name*

Address*

ZIP code*

City*

Country*

Telephone*

E-mail*

The product

Purchased machine*

Purchase date*

Machine serial n°*

Invoice number*

Distributor*

Distributor address*

Distributor ZIP code*

Distributor city*

Distributor country*

(1) I have read the the Mixer warranty terms

I agree to receive information from Mixer

* Required fields

Safety code