First Name

Last Name

Phone *

Email *

Address

Street Address *

City

State

Country

Postal code

Product Selection *

Heat Pump Information

Heat Pump Serial Number
Heat Pump Model Number

Number of AC Single Split Units

First Indoor Head Unit
First Outdoor Unit
Second Indoor Head Units
Second Outdoor Unit

Single Split Air Con Serial Numbers

Outdoor Unit
Outdoor Unit
Indoor Unit
Indoor Unit

Number of AC Heads

The Number of Indoor Units for a Multi Head

Multi Head Serial Numbers

Outdoor Unit
Outdoor Unit
Indoor Unit 1
Indoor Unit 2
Indoor Unit 3
Indoor Unit 4
Indoor Unit 5
Indoor Unit 6

Purchase Date *

Installation Company Name

Installation Date *

Upload of Purchase Receipt

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Do you want extended Warranty

The above information is accurate. I confirm that this warranty does not cover non-product / non-manufacturing faults and the company / person who has requested this service call will be charged according to the prevailing rates. I confirm I have read and understood the Terms of use.

I confirm that I am over 18 years of age and provide my express consent to be contacted by Smart Power Tech Pty Ltd (SPT) and its authorised partners regarding energy efficiency upgrades, product purchases and related services offered under the Victorian Energy Upgrades (VEU) program.

I understand that this consent permits SPT and its authorised partners to contact me via telephone or email for the purpose of providing information about prescribed VEU activities, as defined by the Essential Services Commission and relevant Victorian legislation.