Appliance Recall Refund Request Form

Appliance Recall Refund Request Form
Submit your request for a refund related to a recalled appliance. Complete all sections to help us verify your eligibility and process your refund efficiently.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Model Name or Number of Appliance
Serial Number of Appliance
Date of Purchase
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Purchase
Describe the issue or reason for recall refund request
Upload proof of purchase or photo of appliance label
Cancelof
Should be Empty: