Name
*
First
Last
Email
Phone Number
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Alt Phone Number
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Address
Street Address
Address Line 2 (Suite / Apt #)
City
State / Province / Region
Postal / Zip Code
Product
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ARTIC AIR
AMANA
ASKO
AVANTI
BEVERAGE AIR 185
BADGER
BEKO 185
BERTAZZONI 185
BLUESTAR 185
BROWN
BROAN
BOSCH
BRADFORD WHITE
CAFE
CALORIC
CARRIER
CHROMALOX
CLIMATROL
CRITERION
CROSLEY
DACOR
DAEWOO
DCS / FISHER PAYKEL 185
DEFLECT-O
DANBY
DYNASTY
ELECTROLUX
EQUATOR 185
EXACT REPLACEMENT PARTS
ESTATE
EWAVE
FISHER PAYKEL 185
FRIGIDAIRE
FIVE STAR 185
GALAXY
GARLAND
GENERAL ELECTRIC
GIBSON
GOLDSTAR
GREENWALD
HAIER
HEARTLAND 185
HELMER
HISENSE
HOTPOINT
IDW-USA
INSIGNIA
IN SINK ERATOR
JADE 185
JC PENNEY
JENN-AIR
KITCHEN AID
KELVINATOR
KENMORE
L-G
LACANCHE 185
LACORNUE 185
LIEBHERR
LITTON
LYNX 185
MAGIC CHEF
MAYTAG
MIDEA
MIELE
MODERN MADE
MONOGRAM
MONTGOMERY WARD
PANASONIC
PEERLESS
PERFECT AIRE
PREMIER
QUASAR
ROBERT SHAW
RCA
REGENCY
REVCO
ROPER
RUUD
SAMSUNG
SANYO
SUNBEAM
SEIMANS
SHARP
SMEG 185
SPECTRA
SPEED QUEEN
SUMMIT
SUNRAY
SUPCO
SUB ZERO
TAPPAN
THERMADOR
THOR 185
TOSHIBA
TRUE 185
ULINE
UNASSIGNED
UNIVERSAL
VENMAR
VENTLINE
VERONA
VIKING
FRIDGIDAIRE
WHYNTER
WOLF
WOODS
WHIRLPOOL
WHITE WESTINGHOUSE
Brand
*
Air Conditioner CENTRAL
Air Conditioner WINDOW
Cartridge
Washer/Dryer Combo
Cooktop Electric
Cooktop Gas
Cooktop Induction
Dehumdifiers
Disposer
Dryer Coin Op
Dryer Electric
Dryer Gas
Dryer Stacked Electric
Dryer Stacked Gas
Dryer Top Load
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Dish Washer Built In
Dish Washer Portable
Fireplace
Freezer Chest
Freezer Commercial
Freezer Upright
Freezer Column
Hot Water Tank
Ice Machine
Laundry Ctr Dryer
Laundry Dtr Washer
Stand Mixer
Microwave Built In
Microwave Commercial
Microwave Counter Top
Microwave Over Range
Microwave Oven Combo Wall
Pkg Thermal Air Conditioner
Range Dual Fuel
Range Electric
Range Gas
Range Induction 185
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Ref Bottom Freezer
Ref Built In
Ref Commercial
Ref French Door
Ref Mini
Ref Side by Side
Ref Top Freezer
Ref Column
Small Appliance
Trash Compactor
Vent Hood
Washer Coin Op
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Washer Stacked
Washer Front Load
Water Heater
Wine Cooler
Wall Oven Double
Wall Oven Microwave Combo
Wall Oven Single
Washer Top Load
Product
Model
Serial
Thank you for providing your complete model and serial number from the appliance tag. It gives us a lot of information and can help us complete your repair faster.
Purchase Date
An accurate purchase date is required for warranty service. If your product is out of warranty then only the year of purchase is required. Thank you.
MM
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DD
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YYYY
 
If this is warranty please provide the Dealer that you purchased the appliance from
ABC WAREHOUSE
AMAZON
ANDERSON'S
APPLIANCE CENTER
BEST BUY
BIG GEORGE
COSTCO
DUROCHER'S
FRANK'S SALES
GOEDEKER'S, BALLWIN, MO
HOME DEPOT
IKEA
LOWES
HOME CENTER
MARTINS HOME CENTER
MENARDS
SEARS
WILMAR
WHIRLPOOL
Dealer
If Dealer is not in the list
City
 
Problem
Request Date/Time
(This is only a request. Someone will contact you shortly to schedule an appointment.)
AM
PM