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TRACK YOUR DELIVERY

1480 South Military Trail
West Palm Beach, Florida 33415

(561) 967-8600

Service Request

First Name

Last Name

Address 1

Address 2

City

State/Province

Zip Code

Email

Home Phone

Secondary Phone

Type of Appliance

Brand of Appliance

Date of Purchase

Where Purchased

Model #

Serial #

Problem With Appliance

Do you have extended Warranty?

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Repair & Service