SERVICE FORM No.

Date:

Fossil India Pvt Ltd

#621,12th Main, HAL 2nd Stage,

Indiranagar Bangalore 560008

VAT/CST:29140774965

Call Center Number - 18604253747

Email: service.in@fossil.com

Complaint Details: Stock Watch Customer Watch √

Customer Name: Mobile:

Customer Address: Phone:

City and Pin Code E Mail:

Brand: Model No:

Serial No: Purchase Date:

Warranty Card: Chargeable Free

Expected Date of Completion of Repair: Estimation Required: Yes No

Repair / Service Required Repair details/remarks

Particulars Condition in which received Estimate (Rs.)

Crown

Stem

Casepipe

Battery

Battery Insulator

Glass

Screws

Spring Bar/Side Bar

Case

Overhauling

Bracelet / Strap

Buckle /Clasp

Others

Total

Remarks: Terms & Conditions:

1) Watches will be delivered only on production of the original Watch Repair Form

2) Fossil India Private Limited ("the Company" shall not be responsible for watches not collected within 60 days of
expected date of completion of repair mentioned above

3) Prices of spare parts are inclusive of taxes at current rates

4) The estimated charges are only provisional, and the customer agrees to pay for the charges as assessed by the
Company based on the work carried out
I agree & request you to proceed with the repair of the watch
5) Payment Terms: by cash/credit card on delivery
Customer signature
6) The repair/parts carry a warranty of six months from the date of repair
Dealer Signature
7) Any disputes shall be subject to the jurisdiction of the courts at Bangalore

I confirm having received the watch in good working condition Repaired by:

Customer Signature: Date of completion:

Date: Despatch Details: