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* Denotes compulsory information that must be provided to set up your warranty.
However, we do urge you to spend a few minutes filling in the entire form. This will help us provide you with better and more appropriate services in the future.
Please make sure that all fields marked * are completed.
Title
* First name
* Surname
Appliance Details Potterton Gold Combi HE
Serial Number ABC041000311AP
Address
City
County
Postcode
* Phone
* Email
I am the Owner occupier Tenant Landlord
Landlord/council name
Installer name
Installer CORGI registration number
Mobile
Phone
Email
