Warranty

First Name:

Last Name:

Email:

Address:

Address:

Apt#

City:

State:

Zip:

Phone:

Cell:

Serial#:


Store of Purchase:

Store Address:

Store City:

Store State:

Store Zip:

Invoice#

Price of Furniture:

Price of Protection:

Month of Delivery:

Day of Delivery:

Vendor/Manufacturer:

Description of Item:

Model#

Color:

Damage:


Notes:

Complete Protection

Upholstered Sofas, Sectionals, Easy Chairs, Draperies, Dining Room Chairs, Throw Pillows, Fabric Wall Coverings (Tapestries), Waiting Room Chairs, Office Furniture, Yacht and Automobile Interiors, Rugs and Carpets.