Machine Repair and Maintenance Form

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1. CONTACT DETAILS
 
 
Please choose if you are an end-user or distributor

 
2. TOOL & REPAIR INFORMATION
 
Please enter the serial number for the machine here. If you have any other machines that require a repair then please complete a new form for each machine.
 
 
Nature of Fault









 
By entering an amount here we will proceed to carry out the required repairs up to that value without contacting you. If the repairs are more than this amount we will provide you with a quotation before commencing the repair.
 
3. COLLECTION CONTACT DETAILS
 
Are the collection contact details same as listed above?

If No, add the collection contact details below. If Yes, proceed to section 4. (Collection Date & Time)
 
 
4. COLLECTION DATE & TIME
 
 
 
I have read and accept Mirka’s privacy policy available at https://www.mirka.com/top/privacy-policy*
 
I agree that my contact details can be used for customer services, marketing communications and technical support
 
Thank you for completing the Repair Request form. If you have pre-authorised a repair limit we will arrange for collection of your machine, otherwise we will send you a quotation by email for the required repairs.
 
* Required fields