create-claim · A.H. Beard

First Name

Last Name

Phone Number

Street Address

Suburb

State (If Applicable)

Post Code

Country

Issue

Summary of question or concern:

When did you first notice a problem?

Does the mattress have any marks or stains?

NoYes

Store of Purchase

Product Model

Invoice / Receipt Number

Product Size

Original Purchase Date

Have you read the terms and conditions of the warranty?

NoYes

Are you the original purchaser of the product?

NoYes

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