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For service, login to submit a claim, call 877-634-0964 or click here.

Claims Facilitation Form

Customer First Name:

Customer Last Name:

Customer Phone (Digits Only):

Sales Order Number:

Customer Email:

Communication Preference:

Phone

Address:

Is this a business?

Yes

City:

State:

Zip:

Product Description:

Model:

Manufacturer:

Purchase Date:

Serial:

Retailer:

Unit Failure Description:

Accidental Damage Claim:

Furniture Claim:

Date Failure was Identified:

Attach Invoice and/or Images:

Person Submitting Request:

Person Submitting Request Phone:

Person Submitting Request Email:

Date of Request:

2025-Jun-09