SIGMA Mount Conversion Service Application Form

Customer Information Date: Contact Information* Tel:

Applicant Name* Fax: Mobile: Email:

Applicant Address*

SERIAL NO.* PRODUCT NAME (SIGMA LENS)* CURRENT MOUNT* PURCHASE DATE*

MOUNT PHOTO LENS MFT SE CONVERT TO: * CANON SIGMA (Micro Four-Thirds) (Sony E-Mount)

CINE CONVERT TO: * CANON SONY

Terms and Conditions: 1. The word "SIGMA" means "SIGMA CORPORATION ()". 2. For assistance, please contact Gentec Service at [email protected] or www.gentec-intl.com/service 3. Original parts removed will not be returned. 4. It is not possible to convert a lens to a mount that SIGMA has not released. 5. Depending on the condition of applicant's lens, SIGMA may not be able to accept it for the Mount Conversion Service. 6. Depending on the condition of applicant's lens, additional repair work may be necessary at additional cost. 7. This service does not apply to damage, defects or malfunctions caused by use not in compliance with the instructions, improper use, impact, being dropped or contamination caused by, for example, moisture, sand, dust, dirt, or fungus. 8. For conditions of this service or warranty, excluding its term, please refer to your SIGMA Canada warranty information. 9. The warranty will be effective only for the converted parts, should they become defective, for a period of six (6) months or balance of the original Sigma Canada warranty.

I hereby confirm that I agree to the SIGMA Mount Conversion Service Conditions as above.

*REQUIRED INFORMATION Applicant Signature*

For Gentec International use only: Reception Date Subsidiary/Distributor NAME (Company Stamp & Signature )

For SIGMA's use only: Reception Date Remarks