Inquiry form

1
Input information
2
Review information
3
Registration completed

Please fill in the following information. An asterisk (*) indicates a required item.

After completing the form, click the "Review Information" button at the bottom.

The personal information you input here will be encrypted and sent by SSL, meaning that you can trust it will be safe.
In order to prevent character corruption, please don't use special characters.

Please be aware of the following when entering your email address.
This form is configured to trigger an automated response email.
In some cases the automated response email does not go through when the email address contains a series of periods or emoji.
Restrictions on email you receive may also cause the email to not be delivered.
If the email has not arrived after a short time, please check your spam folder.

Name*

Ex. Jane Doe

Company name / employer

Ex. Citizen Machinery Co., Ltd.

Email address*
Phone number*

Ex. 03-1234-5678

Country*
Inquiries*
* Please make sure to fill in the below if you ask for after-the-sale service.
Machine type
Machine number
Inquiry*
SECURITY CODE*
 * Enter the following characters.
 
CAPTCHA Image
Personal Information
and Privacy*
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