Mr C Williams Flat 1, 285 Knowsley Road Bootle Bootle L20 5DE

15th April 2011 Dear Mr Williams We have introduced a new repair process for the Apple iPhone 4, (if you do not have an iPhone please contact our Customer Services team on the number below). This documentation replaces the front page of your claim form, and you should refer to the information below. What happens next? This process uses the Apple Advance Replacement Service to repair your damaged device, and we need you to understand what will happen so that we can minimise the amount of time you are without your phone. 1. 2. We need you to complete the claim form, sign it on the back, and return it to us. Once we have received your claim form and the claim has been accepted, we will provide you with further details for contacting Apple and how to use the Advance Replacement Service. 3. The Service can be accessed through an Apple store, by phone or over the web. Apple will arrange to have a replacement device sent to you. 4. By using the Service, you will be entering into an agreement directly with Apple and you will be responsible for the payment of the costs involved. 5. Once you have received your replacement device, it is very important that you return your damaged device to Apple within 10 working days. If you do not send your device back within this time, you will receive further charges which we cannot be responsible for. 6. There is an upfront charge to pay to use this service, which is paid directly to Apple by credit or debit card. Within 10 working days of us receiving your Genius Bar invoice we will have transferred a payment for the service you have received, up to a maximum of 149.18 + VAT (minus your excess fee) directly into your bank account.

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Important things to do:

Please DO NOT SEND YOUR PHONE ANYWHERE UNTIL ADVISED TO BY US. Before you commit to an agreement with Apple we need to confirm that your claim is accepted and that we will be responsible for the costs.

If you use the Apple Advance Replacement Service without us accepting your claim, we may not refund the charges.

You should only return the damaged device in the packaging provided by Apple. You MUST NOT return your device to us.

Please ensure that you remove your SIM card before returning your damaged device and if possible sync and back up any data through iTunes. You should return the SIM card tray with the device.

Please remember to complete all the sections of the claim form in full and return it to us as soon as possible.

Whilst we are paying for the charges, the arrangement is between you and Apple. There are Terms and Conditions for this service supplied by Apple which you will need to agree to before using the service; we recommend that you understand these as there are charges which will be applied if the terms are not followed. Address to return the claim form to: PAS Apple Claims Policy Administration Services Ltd PO Box 99 Blyth NE24 9DN If you require any further assistance, please call our Customer Services team on 0844 871 0600*, from Monday to Friday between 8am and 8pm, or on Saturday or Sunday between 9am and 6pm.

Yours sincerely

Ross Carson Head of Customer Services

*0844 calls will be charged at a maximum of 5p a minute from a BT landline. Calls may be recorded or monitored for quality purposes and for the prevention/detection of crime. Details correct at time of creation.

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For more information regarding the Apple Advance Replacement Service, please read the following FAQs. 1. How long will it take to receive my replacement?

Your replacement will arrive approximately one to two business days after you request it from Apple. 2. Will the replacement be the same model as the one I purchased?

Yes, Apple will send you the same model with the same specifications as the device you originally purchased. The replacement device will be new or equivalent in performance and reliability. 3. Will I have to activate my replacement device?

No, there is no need to activate the replacement. Simply transfer the SIM card from your original device to the replacement. Then sync your replacement device with iTunes while connected to the Internet. After that, you will be able to use the device as normal. Note: Make sure to remove your SIM card prior to delivery of your replacement device. 4. How much could I be charged if I dont return my damaged phone to Apple?

The costs change from time to time. Please refer to the current details on the Apple website at apple.com/uk/support/iphone/service/exchange/ 5. Will I have to pay any other charges?

When Apple receives your original device you will be charged the Cover Charge, which we will reimburse to you after we receive your Genius Bar invoice. If you do not return your original device to Apple within 10 working days, you will be charged an additional amount, up to the cost of a new device.

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INSURANCE CLAIM FORM - CONTRACT & SME ACCIDENTAL DAMAGE

Please note this claim form should be returned within 14 days of receipt

ClaimNo: PolicyNo: Excess :

5816442 11031751 50.00

Please Complete in Black Ink Only 1. Confirmation of phone details

Below are the current phone details we believe you are claiming for, if not please amend and provide a copy of your receipt for your new phone.

IMEI Number

012545004633145

Make & Model of phone

Apple IPHONE 16GB BLACK ORA

Please Confirm which network you are with: 3 BT O2 Orange T-Mobile Virgin Vodafone Other

2.Incident Details
Location/Premises e.g Public House, car, work

Date of Damage

Please describe as fully as possible how the damage occured.

3.Accessories information
a. Are you claiming for accessories not supplied with the phone? b. If yes, please provide a receipt for the accessories Yes No

4. Your contact details

- We may need to contact you to discuss your claim. To assist us, please complete your contact details in the box below.

Daytime Is This: Telephone Number

Evening Telephone Number

Alternative Mobile Number SMS/Text E-mail Address

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Claim No: Name:

5816442 Mr C Williams

5.Your Delivery Details

If your claim is accepted we will replace your phone with the same make and model. If that phone is not available, we will contact you to discuss an alternative. We will send your replacement phone to the address on the letter which accompanies this claim form. If you wish us to send it to an alternative address, please complete the details below.

Address Line 1 Address Line 2 Address Line 3 Address Line 4 Postcode

If you would like us to inform you that your replacement phone is on it's way, we can do this by sending you an SMS / Text message. Please provide the number to which this should be sent.

SMS / Text Contact Number

6. Declaration
I declare that the information provided on this form is complete and correct whether I, the policyholder, have completed the form, or someone else has done so on my behalf. I enclose my excess payment of 50.00 and all the necessary documents to support my claim. I give my permission, and this is my authority, for both the police and my network provider to release any information required to assess my claim.

Signed

Dated

EXCESS PAYMENT

Please ensure you complete this section in full. Failure to do so will result in a delay in processing your claim.

7. Credit/Debit Card Details

- please complete if this is your preferred method of payment for your excess.

Alternatively include cheque/postal order with your claim number written on the reverse.

I authorise Policy Administration Services Ltd to take the payment of 50.00 from my debit/credit card Please note Electron Cards are not accepted Long card No (No Spaces) (Switch/Maestro/ Solo only)

Issue No

Valid From

mm

yy

Expires

mm

yy

Name on Card

Cardholder Signature

Dated

IIf you do not wish to pay by credit / debit card, we can also accept cheques or postal orders made payable to: Policy Administration Services Limited. Please write your claim number on the reverse.

PLEASE DO NOT SEND CASH

*PCLF5816
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REPAIR CENTRE NOTE

Customer Details
Customer Name: Claim ID: Policy ID: Mr C Williams 5816442 11031751 Address: Flat 1, 285 Knowsley Road Bootle Bootle L20 5DE

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Mobile Device Details
Make and model: Network: Apple IPHONE 16GB BLACK Orange IMEI: 012545004633145

Your Contact Details

Please provide a telephone number we can contact you on in the box opposite.

Please indicate below the problem(s) you are experiencing with your mobile device stating whether it is a permanent or intermittent fault.
FAULT Mechanical Permanent Intermittent FAULT Software Permanent Intermittent

Screen damaged Charge port broken Keyboard/joystick SIM reader/SIM holder Side control button faulty
Electrical

Wrong version/update issue Internet/GPS/WiFi Infrared/Bluetooth/MP3 Unit locked SIM card problem/unrecognised
Network

Doesnt switch on/off Temporarily switches off Charging fault Battery not holding charge
Display/Touch Screen

No Network Poor network connection Calls cut out automatically 3G/WLAN

Multimedia/Accessory

No function at all Defective segment e.g. lines Backlight faulty

Audio

Camera/video functionality Data transfer via cable (USB) Access to memory card Accessory problem
Liquid contamination

Speaker/microphone Noise/echo during call Ringer/vibrator

Please describe how often/when the fault occurs

If you have any additional information which may assist us with the repair of your device, or the problem is not shown on the list above, please provide the details in the box below.

Please note - as part of the repair process we may upgrade the software installed on your device. Please be aware that we cannot be held liable for any compatibility issues this may cause with other equipment you use in conjunction with the device.

If you would like your repaired device sent to an alternative address to the one shown at the top of this page, please provide the details in the box opposite.

Postcode

*PCLF5816
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