*First Name  

*Last Name  

*Email Address  

*Phone  

*Street Address  

*City  

*Province  

*Postal Code  

*Serial No. (14 or 16 digits) 

*Date of Purchase  

Receipt / Proof of Purchase ( 2MB limit )  

*Provide detail about the issue  
you have encountered  
( Up to 500 characters )  

Order ID  

Case ID  

Attachment ( 2MB limit )  

Note: To send multiple files, attach as a .zip or .rar