Parts and Damage Replacement Procedure
Model Number
Part Letter Code
Quantity
A COPY OF YOUR PURCHASE RECEIPT OR INVOICE MUST BE ATTACHED TO THIS ORDER FORM.
NO ORDERS WILL BE PROCESSED WITHOUT PROOF OF PURCHASE.
NAME: ___________________________________________________________________________
ADDRESS: ___________________________________________________ (No Post Office Boxes)
CITY: ___________________ STATE: _____________________ ZIP: _____________________
PHONE: _________________________________ FAX: __________________________________
EMAIL: ___________________________________________________________________________
REASON FOR REPLACEMENT/PLEASE CHECK APPROPRIATE BOX.
( ) Damaged /scratched, cracked, broken, crushed, etc.
( ) Mechanical malfunction/ drawer glides, swivel mechanisms, lid stays, etc.
( ) Missing pieces
( ) Unfinished surface
( ) Wrong color
( ) Other
IF MORE THAN ONE MODEL NUMBER IS LISTED ABOVE, PLEASE SPECIFY THE EXACT MODEL NUMBER OF YOUR
ITEM IN THE SPACE PROVIDED BELOW.
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