BM – Platinum Repairs: Trustworthy Tech Repairs In South Africa

Claim #*

First Name*

Last Name*

Phone Number*

You can add more than one number if needed. Put "0" if we should contact via email only

Email Address

Damage Report, Repair or Salvage?*

Damage Report
Repair
Salvage

Risk Address

Please add your address, and collection notes, if needed: Eg: Please hoot at the gate, intercom broken.

Will the device be returned to the same address?

Will the device be returned to the same address as where it was collected from? The delivery address can not be different to the collection address.

Yes
No

Additional Contact Information:

Device Make

Device Model

Device Capacity

Colour

Damage / Problems Experienced / Notes

Data Use Consent*

I have read, and agree to the conditions explained in the linked document, with regards to the use and protection of my data, in terms of the POPI act. Platinum Repairs have to comply with the new legislation and require your consent to process your data. Your data will be safe and will not be shared.

Yes