Claims - Multi X

In this form you can submit a claim regarding Multi X, Arka, and Latitude 45 products.

Full Name *

Please enter your full name.

Email *

Please enter a valid email address.

Phone *

Please enter your phone number.

City of Purchase *

Please enter the city of purchase.

Purchase Date *

Please enter the purchase date.

Place of Purchase *

Please select the place of purchase.

Request Type *

Please select a request type.

Subcategory

Was there any injury?

Description

File (image or document) Max size: 5MB. Accepted formats: JPG, PNG, PDF, DOC, DOCX.