Ellies - Register Warranty

Serial Number*

Product Name*

Model No*

Date of Purchase*

Original Purchaser Name*

NRIC*

Date of Birth*

Full Address*

Handphone*

Email*

Tel

Dealer Name

No, 41, Jalan Taming 4, Perindustrian Taming Jaya,
Off Jalan Balakong, 43300, Seri Kembangan,
Selangor, Malaysia.