Mattress Warehouse: Customer Service: Warranty Claim

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	Warranty Claim:	* = Required field
	Complete the form below to request warranty service to be performed on merchandise in your home. If it is determined that your merchandise needs to be inspected, we will notify you with further instructions. Product Information: Store Location Where Purchase Was Made: Date of Purchase: Invoice Number: Merchandise in Question: Reason for Claim: Your Information: First Name: Last Name: Address 1: Address 2: City: State: Zip Code: Phone Number: Fax Number: *Email Address: Comments/Questions:

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