Brills Marketing - Customer Service Portal

Service Request Form

All fields marked with * are required

Customer Information

Customer Name *

Complete Address *

Mobile Number *

Alternate Mobile (Optional)

Email Address (Optional)

Confirmation email will be sent here if provided.

Service Details

Type of Service *

Model / Unit *

Qty

Equipment Details (optional)

Date of Purchase (Optional)

Cannot be a future date.

Serial Number (Optional)

Purchased Store (Optional)

This unit is under warranty

Proof of Payment

Upload Receipt / Proof of Payment *

Required for Install

Click or drag to upload receipt

JPG, PNG, WEBP, GIF - Max 5MB

File selected

Upload your official receipt or transaction screenshot as proof of payment.