Repairer Notification Form

Incident Date: 17/10/2011

Consumer Name: ABD MUNIL BIN HASIM Address: KAMPUNG BARU JLN PANJANG KG AWAH TEMERLOHPHG Telephone No: Mobile No: Program Client: Courts Mammoth Berhad Contract No: CORT83603263 Sales Order #: Customer Service Representative: RAMLAN BIN MEON

Pending Claim No: 400131650

Repairer: TVC ELECTRONIC Address: NO 3 BANGUNAN PASDEC JALAN BETONG JERANTUT MALAYSIA Product: Refrigeration Brand: PANASONIC Model: NR-B261M Serial No: 90512566 EW Start Date: 29/07/2009 EW Expire Date: 29/07/2014

Service Type

New Job Order X

Rework Job Order

Follow-up with Customer on Repair Status

Symptoms: NCOO-No cool 0148296613 Repair History: No Claims History Incident Date Repair Completion

Claim #

Service Performed
( set tiada jaminan sebab kena kilat ic di power pcb pecah)

Call the Extended Warranty Claims Department for Quotation if this Repair exceeds RM 350.00. Repairs exceeding the limit where no authorization is obtained will result in non-payment of repair. To obtain repair authorization, please call 03-20585224 / 23 / 22 / 11 / 05 during business hours.
Conditions: 1) This Repairer Notification Form validates and confirms that the consumer has a valid Extended Warranty contract underwritten by Chartis Malaysia Insurance Berhad (CMI General Insurance). 2) Follow the CMI General Insurance Claims Procedures to ensure timely service, processing, and payment. For onsite service: a) Call the customer the same day if you receive this Repairer Notification Form before 4:00PM. b) Call the customer by 12:00PM the following day if you receive this Repairer Notification From after 4:00PM. 3) As our agent for service, we ask that you act on our behalf to eliminate claims of abuse, neglect, acts of God, etc. Any services that fall outside the Extended Warranty Terms and Conditions is the account of the customer. 4) Sub-contracting work to a 3rd party servicer is subject to, the written approval of CMI General Insurance. 5) By acceptance of this repair notification, you as a repairer agree to keep all personal data stated on this repairer notification secured and protect from unauthorized or accidental access, processing, erasure, and other uses. Should you have any concern and/or difficulty abiding by this agreement, please contact our Data Privacy Office. Information transferred to any other company must have the approval of CMI General Insurance.

Customer Service # Toll Free

1-800-18-1108 (Courts Mammoth Berhad) or Tel # 03-20585224 Fax# 03-20585078