Sedgwick Business Interiors > Contact Us

Repair Request Form

First Name:		*
Last Name:		*
Company:		*
Phone Number:		*
Email:		*
Was this product purchased through Sedgwick Business Interiors:
	Yes No Unknown
If yes, please list your Account Executive and/or any purchase or acknowledgement numbers:

Product Type:

Description of Damage:

Warranty Repair:
	Yes No Unknown
Attach photo of damage:

Ship to Address
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Address Line 2:
City:
State:

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Additional Comments:

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