ROBERTSON WORLD WIDE - INNOVATIVE LIGHTING SOLUTIONS

Warranty Claim Form

Our goal is to provide customers with the best possible service. Please provide all the information requested below. The completed form aids in this process.


CUSTOMER CONTACT INFORMATION

REQUIRED  Last Name:
REQUIRED  First Name:





REQUIRED  Address:
Apt.:





REQUIRED  City:
REQUIRED  State:
REQUIRED  Zip:







Phone Number:
Fax Number:





Job Site:



REQUIRED  Email Address:






PRODUCT INFORMATION


Total Quantity of Units:

Quantity of Defective Units:

Robertson Catalog Number:

Version (what's this?):

Voltage Used:

Lamp Type:

Fixture Manufacturer:

Date of Fixture Installation:



REQUIRED
    * Lot/Date
   Code Number:
 



   Describe
   Problem:
 


REQUIRED
 Required Fields
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 Fields Needing Attention
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* NOTE: Robertson places a Lot/Date code label on each unit shipped from the factory. This is a label (looks like a price tag) with two rows of numbers, usually. Please record all the numbers listed on the label in the Lot/Date Code Box above.

NOTE: Before shipment of replacement product, any additional costs must be pre-approved by Robertson Worldwide. For any questions on this procedure, please contact the Warranty Department at 800-323-5633, dial 5 or email us at warranty@robertsonww.com
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