Claims request form

Please fill ou the form below to submit your claims request. A representative will contact you shortly.

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Contract Number:

Name: *

E-mail address: *

Telephone: *

Address: *

City/State: *

Brand of Appliance:

Appliance type: *

Description of problem *

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Claims request

Appliance Guardian

Phone: 708-758-7913

E-mail: claims@applianceguardian.net

Online request: click here

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