|
(Cut and Paste to a Word Document to Print)
Customer
Warranty Claim Request
In an effort to assist you with your Warranty Claim, please answer the
following questions as completely as possible. Please attach a copy of
your original customer receipt to this document and return it to:
MT VERNON SLEEP CENTER 3500 PLANK RD SUITE E FREDERICKSBURG VA
22407
Customer’s Name: _____________________________________________________
Telephone: ______________ (home) ______________ (fax)
______________ (work) ______________ (Cell)
Address: ___________________________________________________________
Address: ___________________________________________________________
City: _______________________________ State: ____ Zip: _________
Dealer: ______________________ Date of Purchase: ________ Price: _____
Street Address: ________________________________________________________
Dealer’s City _____________________________ State: _____ Zip: _________
Merchandise Identification
Note: If the merchandise is a Mattress or product that has a law tag, write
the model number and warranty code below. Some information will be present on
the store receipt.
Name of Manufacturer: ___________________________
Model Number: ___________ Warranty Code: ______
Date Manufactured: ________ Model Name: ________
Mattress and Box Spring Information
Size: ( ) Twin ( ) Full ( ) Queen ( ) Cal King ( ) King ( ) Other
Is this mattress a pillow top model? ( ) Yes ( ) No
Describe problems or concerns dealing with Mattress: _________________
_____________________________________________________________
_____________________________________________________________
| ( ) Body depression problems (
) Seam or Fabric Problems
( ) Spring Breakage
( ) Coil or Wire protruding
( ) Other _______________ |
 |
If a Body Depression is
present, circle the area of the body depression.* The frame has a dip of
_________inches.
*Body Depressions are to
be measured by laying a straight edge across the mattress, and measuring
from the straight edge to the mattress surface. Both the mattress, Box
spring, and frame must be measured for body depression problems.
Measurements are to the nearest tenth of an inch, and are to be measured to
the top of the quilt, not into a seam or tuft. Most body depression claims
require a service call, which in the Fredericksburg area costs $45-$90.
This charge is refunded if the merchandise is covered under warranty. The
transportation costs in replacing a mattress are not covered by the
manufacturer. Please call or stop by our showroom with any questions
pertaining to the warranty process.
Bed Frame Information (This must be filled out for a mattress
warranty claim)
Please check which diagram best described your frame:
For All Other Merchandise
Please indicate on the form below the type and extent of the warranty
problem:
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________ ____________If
more room is needed, please feel free to write on back of form.
Disclaimer: The merchandise we sell falls solely under the warrantee of the
manufacturer. In an effort to assist our customers in warranty related issues,
we provide this form and will transfer the paperwork which decreases the amount
of time taken by the warranty process. We are not involved in the decision
process of what is covered under a manufacturer’s warranty, nor are we
responsible for broken merchandise not covered under the manufacturer’s
warranty. If a manufacturer approves a warranty request, the shipping of the old
and new merchandise is the responsibility of the customer. Also, any consumer is
free to file a warranty claim directly to the manufacturer without our help.
If another Copy of this form is needed, please go to
www.Mtvernonsleepcenter.com, and click on Warranty for a printable version.
|
