SERVICE REQUEST
Personal Information of Contract Purchaser:
First Name:
Last Name:
Best Contract Phone Number:
Email Address:
Address Where Unit is Located:
City:
State:
Select
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Zip:
Equipment Detail:
Product Description:
Manufacturer:
Model:
Serial Number:
Date of Purchase:
Failure Details:
Detailed Description of Unit Failure:
Describe all troubleshooting performed:
Accidental Damage Claim:
No
Yes
Who was using the item?
Where did the incident occur?
When did the accident occur?
How did the accident occur?
What is damaged?
Furniture Claim:
No
Yes
Date Failure was Identified:
Attach Invoice and/or Images:
I accept the
terms of service
I have completed all manufacturer suggested troubleshooting. I acknowledge that if it is determined that the service provided on my product is not covered under the Terms & conditions of my service plan, I will be responsible to pay the service provider for the service call. I may also be responsible for mileage charges outside of a certain radius per my Terms and Conditions.
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Verification Code:
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Type the text:
Be as specific as possible
Explain what is not functioning properly. Be as specific as possible.
Please attach images if this is a furniture claim.
Please attach images if this is an Accidental Damage from Handling claim.