It is important for you to provide as much information as possible in order for us to help address your concern. We may need to contact you directly to gather further information or to clarify information provided. If you would like to speak to someone directly you can call 1-800-824-3005 (USA) or 1-800-405-5320 (Canada).

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CONTACT INFORMATION

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PRODUCT INFORMATION

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THESE CAN BE FOUND ON THE PACKAGING AND / OR PRODUCT. YOU MAY ENTER MORE THAN ONE PRODUCT NUMBER.

Date Purchased *

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Installer Information

APPLICATON / INSTALLATION INFORMATION

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SAMPLES MAY BE REQUIRED FOR ANALYSIS PRIOR TO CONCERN RESOLUTION

Comments

I agree to provide my personal information to Leviton for use in accordance with its Privacy Policy. *

For California residents only. In accordance with the CCPA, I understand that I may be providing the following Categories of Personal Information (as defined in the CCPA) to Leviton by completing this form: Identifiers, Commercial Information, and Internet or other similar network activity, for the purpose of fullfilling my request.

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I have read and understand Leviton's Privacy Policy. *