Pick Up Request

Return Case ID / Warranty Case ID
Eg: RHA1234 or RET123
Full Name
Address Type
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number
Email ID
Pick-Up Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
If you're filling this form after 12 PM, a pick up for the same day will not be possible. It can only happen on the next working day (Sundays not included).
Return Case ID / Warranty Case ID
Eg: RHA1234 or RET123
Should be Empty: