Individual repair form

Name *

First name

Name

Adresse

Address Line 1

City

State / Province / Region

Postal Code

Phone

Provenance de la batterie "REVENDEUR" ? *

Mandatory

Attach the invoice for the origin of the lithium battery

Click or drag a file to this area to upload.

Mandatory

Battery usage:

The battery comes from:

Problem identified:

In case the battery cannot be repaired:

You return the battery - Transport costs at your expense for an amount of €45 including tax.
Dispose of the battery for recycling.
Please wait - Maximum one month after it will be automatically recycled.

Mandatory

Additional information: