YOUR INFOMATION:
First Name:
*
Last Name:
*
Email:
Phone #:
Alt. Phone #:
Street:
Suite/Apt #:
City:
State:
Zip Code:
YOUR PRODUCT:
Brand:
AGA
AMANA
BERTAZZONI
BLOMBERG
BOSCH
BROAN
GE CAFE
CAPITAL
DANBY
DCS
ELECTROLUX
FABER
FISHER & PAYKEL
FRIGIDAIRE
GAGGENAU
GENERAL ELECTRIC
HOTPOINT
JENNAIR
KAMADO JOE
KITCHENAID
LG
LIEBHERR
MARVEL
MAYTAG
MIELE
GE MONOGRAM
OTHER NON-SERVICED BRAND
PERLICK
SAPPHIRE
SHARP
SPEED QUEEN
SUMMIT
THERMADOR
U-LINE
VENTAHOOD
VIKING
WHIRLPOOL
WHIRLPOOL
WASTEKING
XO
ZEPHYR
Product:
CASEMENT AIRCONDITIONER
AIR CONDITIONER
BEVERAGE CENTER
COFFEE MACHINE
COMBINATION OVEN
COMPACTOR
CONVECTION OVEN
DUAL FUEL RANGE
DISHWASHERS
DISPOSAL
DRYER ELECTRIC
DRYER GAS
DUAL FUEL OVENS AND RANGES
DOUBLE WALLOVEN
DOWNDRAFT
ELECTRIC COOKTOP
ELECTRIC RANGES
FREEZER
GAS COOKTOP
GAS RANGES
GAS WALLOVEN
HOODS
ICE MAKER
INDUCTION COOKTOP
INDUCTION RANGE
MICROWAVES
MICROWAVE DRAWER
REFRIGERATOR
SLIDE IN ELECTRIC RANGE
SLIDE IN GAS RANGE
SLIDE IN INDUCTION RANGE
STEAM OVEN
SPEED OVEN
SINGLE WALLOVEN
UNDERCOUNTER REFRIGERATOR
WARMING DRAWER
WASHER
LAUNDRY CENTER
Model: (Type ? if unknown)
Serial: (Type ? if unknown)
Thank you for providing your complete model and serial number from the appliance tag. It gives us a lot of information and can help us complete your repair faster.
Purchase Date:
An accurate purchase date is required for warranty service. If your product is out of warranty then only the year of purchase is required. Thank you.
IF THIS IS A WARRANTY, PLEASE PROVIDE THE DEALER THAT YOU PURCHASED THE APPLIANCE FROM:
Dealer:
JARVIS APPLIANCE
If Dealer is not in the List:
City:
PROBLEM:
Request Date:
AM/PM:
AM
PM
(This is only a request. Someone will contact you shortly to schedule an appointment.)