CEW Form APAC Forms

2018-10-22

: Linksys Apac Cew Forms APAC CEW Forms process s

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Connected Equipment Warranty (CEW) for Surge Protector
Please read the below terms and conditions of CEW before submitting the claim form. For detailed
explanation of terms and conditions, please refer to the official Belkin Connected Equipment Warranty
document attached with the product.

1. Belkin Asia Pacific Limited (Belkin AP) will repair or replace, as its option, any
equipment (“connected equipment”) that is damaged by a transient voltage surge, spike
or lightning strike (an “Occurrence”), while properly connected through a Belkin Surge
Protector to a properly wired power line with protective earth. Belkin AP will spend, to
repair or replace the damaged equipment, as its option, an amount equal to the fair
market value of the equipment or the original purchase price of the equipment,
whichever is the less, up to the maximum set on the product retail box.

2. This warranty shall be null and void if the Belkin surge protector has been improperly
installed, altered in any way, tampered with, or if the connected equipment was not used
under normal operating conditions or in accordance with any labels or instructions. All
Belkin surge protectors must be plugged directly into the power source and must not be
“daisy-chained” together in serial fashion with other power strips, UPSes, other surge
protectors, or extension cables.

3. Belkin AP reserves the right to review the damaged Belkin Surge protector, the
damaged equipment, and the site where the damage occurred. All costs of shipping the
Belkin Surge protector and damaged equipment to Belkin for inspection shall be borne
initially by the purchaser. If the claim is approved, the cost of shipping will be
reimbursed by Belkin.

4. We strongly recommend shipping the damaged surge protector with a carrier
who can provide a tracking number. Belkin is not responsible for parcels lost in
transit. If we do not receive the damaged surge protector within 10 business days from
the date of submission of the claim form, Belkin AP will officially consider the claim
closed.

5. The claim must be submitted within 15 days of Occurrence, with an original purchase
receipt.

Please prepare the following document and contact Belkin Technical Support representative. They will
instruct you where to send the damaged surge protector and who to contact to proceed with the claim.
The representative may also ask to forward the damaged equipment for inspection.
1. Completed Claim form.
2. Copy of purchase receipt of the damaged Belkin Surge Protector
3. Copy of purchase receipts of the damaged equipment or an estimate of the repair quote
of the damaged equipment
4. Damaged Belkin Surge protector with your full name written using a permanent marker.

1

CEW Claim Form

Full Name (Firstname, Surname):
Address (where the Occurrence took place):
City:

Country:

Contact Number:
Email:
Belkin Surge Protector Model No. (Start with ‘F’):
Date of Purchase:
Place of Purchase (Store name and location):
Cause of failure (e.g. thunderstorm):
Date of Occurrence:

Please list out all the connected equipment (both damaged or not damaged), which were properly
connected to Belkin Surge Protector during the occurrence.
Connected Equipment

Brand

Model No.

Damaged?

Insured*?

(* Insured by insurance company or Warrant by original manufacturer.)

2

How it connected to Belkin Surge?

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Outlet

Tel

Ethernet

Coaxial

Please list out all claimed equipment with estimated amount. Please exclude those already insured or
warranty by other companies.
Equipment to be claimed

Brand

Model No.

Replaced?

Are you willing to write a customer testimonial for Belkin
after the claim is completed?

Repair?

Yes

Estimated replace/repair Amount

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

Currency:

Amount:

No

(* It is voluntary. The selection will not affect the
claim result.)

I understand that by signing this document I hereby confirm that all information listed on this claim form
are correct and true. If any information that I have supplied is incorrect, Belkin Asia Pacific Limited may
officially close or deny my claim at any time. I have read and fully understand the terms and conditions of
Belkin Connected Equipment Warranty document.

Printed Full Name

_____________________________
Signature

_____________________________
Date

3
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