Sankyo Automation
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Repairs and Maintenance

Use this form for repairs, service, and maintenance of your product.
Fill out the form below and send it to us.
Information about the product to repair or service
Product InformationFill in as much detail as possible by referring to the warranty certificate or the nameplate on the product.
Model name/Product code

Serial number 
* 6-digit alphanumeric code

Date of purchase
 Year  Month (estimate)

Purchased as

Equipment name
Source of equipment  






ProblemExplain the problem you're having, or specify details on regarding your request.
Your information
Company name [mandatory]
Department, Position
Your name [mandatory]
Email address [mandatory]
* Confirm by entering the same email address again.
Phone number [mandatory] (Numbers only)
Fax number (Numbers only)
Address [mandatory]
City/State/Zip [mandatory]





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