Warranty Claim Form

Any further issues please fill out this form.

Date

Name *

Email *

ADDRESS

Address Line 1 *

Address Line 2

City *

State / Province / Region *

Postal / Zip Code *

Country *

Daytime Phone Number:

Date Purchased: *

Order Number *

Where did you get your Bug-A-Salt or Bug-Beam? *

Batch Code: *

This is the white or black sticker you see on the bottom of your Bug-A-Salt typically consisting of 2 Letters then 2 Numbers

Product Description: *

How long did you use your BUG-A-SALT before the issue occurred? *

Has the BUG-A-SALT ever worked? *

Describe the problem with your BUG-A-SALT or BUG-BEAM: *

If possible please upload a photo or video from your phone etc. Photos & videos can be very helpful!

Click to choose a file or drag here

Size limit: 10MB per file