Thank you for choosing an e-bike equipped with Polini E-P3 motor. Enter the relevant information to send the request. Fields with (*) are mandatory.

Motor data

Polini motor serial number

Battery type

Battery serial number

Second battery serial number

Bike model

Total kms traveled (ODO)

Display

Dealers information

Personal data

Company Name

SDI code

VAT/EORI (UK only) number

PEC Email

IBAN

Address

Town

ZIP code

Province

Country

Contact details

Mobile Phone Number

Name

Surname

Pick-up/delivery address is different to the billing one

E-bike purchase invoice

Is the product under warranty?

Attach the photo or scan the e-bike purchase invoice

File format jpeg/pdf max 5 mb

Support request information

Reason for the request (Select a different option than “unknown” only if you are sure of the origin of the problem)

Problem description and tests performed

(Min 20 char - Max 500 char)

Attached

If any, attach the photo/video of the problem
(File format jpg, jpeg, png, pdf, mp4 max 50 mb)

E-bike owner information

Name

Surname

Address

Town

ZIP code

Province

Country

Mobile Phone Number

Attention: the notification e-mail is sent by no-reply@polini.com

Information provided pursuant to Articles 13-14 of GDPR 2016/679 (General Data Protection Regulation)

Rights of the data subject
I, the undersigned/a, hereby declare that I have read the above information.

I, the undersigned/a in accordance with the information:

I give the consent I do not give the consent

to the processing of my personal data including those considered as special categories of data.