Haier Product Registration-Haier Malaysia

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About you

*Given Name :

*Surname :

*Gender :

Male

Female

*Date of Birth :

*Age :

*Country :

*State :

*City :

*Zip Code :

*Street Name :

*E-mail :

*Customer Type :

*Mobile phone :

Telphone :

Product information

*Brand:

*Product :

*Model :

*Serial Number:

*Purchase Date:

*Retailer:

*Retailer City:

Purchase document:

Please upload Original Invoice/Bill.
Format : JPG/PNG/PDF Only

I have read and accept

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