WARRANTY REQUEST FORM

To be completed and submitted by an authorised Rollies dealer only.
If you did not purchase the goods and/or services directly from Rollies, you need to contact your place of purchase for any and all assistance.

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

Name*

First Last

Position*

Business Name*

Address*

Street Address Line 1 Street Address Line 2 City / Suburb Province / Region / State Postal / ZIP Code Country

Phone Number*

Email Address*

Rollies Invoice Number*

Rollies Part Number:*

Bike Year*

Bike Make*

Bike Model*

Please describe the fault/defect in detail*

Please explain how you believe the fault/defect came to be and detail the events leading up to said failure/defect*

Please attach a short video and/or images, clearly depicting the fault/defect*

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 256 MB.

Please attach a copy of the Invoice and/or Jobcard under which you sold your customer the goods in question*

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 24 MB.

The next step varies by manufacturer and we will provide you with all the details for the next step.

Got a question?
(07) 3252 5381

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