Fillable CONSUMER SERVICE WARRANTY CLAIM REQUEST (City of Oakland)

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CONSUMER SERVICE WARRANTY CLAIM REQUEST (City of Oakland)

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The CONSUMER SERVICE WARRANTY CLAIM REQUEST (City of Oakland) form is 2 pages long and contains:

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  • 28 check-boxes
  • 41 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Oakland

BROWSE CITY OF OAKLAND (CA) FORMS

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Name: ______________________________________________________________________________
Telephones: _______________________________ Day / ______________________________ Evening
Address: _______________________________________ Email: ________________________________
City: ______________________________________________ State: __________ Zip: _______________
Dealer: ______________________________ Date of Purchase: _________________ Price: __________
To help identify your mattress and foundation look for these labels and copy the information available
in the places indicated:
Law Tag Information
(Date of manufacturing, ex: 01/01/14)
M
(Mattress pattern number, ex: M12345.60.1234)
B
(Foundation pattern number, ex: B12345.80.1234)
SATIN TRADE LABEL
(sewn onto the mattress)
MODEL NAME:
(ex. Beautyrest World Class Felicity Pillowtop).
NUMBER CODE
LETTER CODE
Indicate any numeric or letter code on label.
Is mattress a pillow top model? Yes No
Is mattress single sided? Yes No
Numeric
Code
Letter
Code
A
A
F
F
B
C
D
C
E
D
In an effort to assist you with your Simmons Warranty Claim, answer the following questions as
completely as possible. Attach a copy of your bill of sale (if available) and photographs of the mattress
(without linens), foundation and the frame unit to this document and return these items to: Simmons
Consumer Service, One Concourse Parkway Suite 800, Atlanta, GA 30328. If the Claim Form is
not fully completed (including photographs), it cannot be processed.
CONSUMER SERVICE
WARRANTY CLAIM REQUEST
For Internal Use Only
Ref. #
Date Mailed
Size: Mattress
Twin
(38 x 75)
Twin XL (38 x 80)
Full (54 x 75)
Full XL (54 x 80)
Queen (60 x 80)
Olympic
®
Queen (66 x 80)
California King (72 x 84)
Eastern King (76 x 80)
Size: Foundation
Standard
Low Prole
Split Queen Boxes
B
Model Name
(EXAMPLE LAW TAG)
(EXAMPLE TRADE LABEL)
E
G
G
F
(Warranty Code, ex: B3, B7, A)
Beautyrest
Consumer Warranty Care : Avenue 2451 Industry Avenue | Doraville, Georgia 30360.
MATTRESS: Please explain your concern;
mark diagram if applicable.
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
_____________________________________
MATTRESS FOUNDATION
TOP BOTTOM
FRAME / SUPPORT:
Check which diagram best describes your frame.
If frame has slats, how many? _______ What type of slats? ________ Distance between slats? _______
For more detailed information, visit www.simmons.com, keyword: Warranty
1. Is the mattress manufactured by Simmons? Yes No
2. Is the foundation manufactured by Simmons? Yes No
3. Does the foundation match the mattress? Yes No
4. Has either the mattress or foundation ever been replaced? Yes No
5. Is mattress stained or soiled in any way? Yes No
If Yes, describe the source and size of stains.
6. Is the foundation stained or soiled in any way? Yes No
If Yes, describe source and sizes of stains.
Customer
Signature ______________________________________________ Date _______________________
Checklist: Warranty Claim Request Bill of Sale Photos
(All items received become the sole property of Simmons Bedding Company and will not be returned.)
If body impressions exist, measure the depression in an area where there is no stitching
by placing a straight edge across the area and using a ruler to measure the depth of the
depression on top of the quilting. Please note the depression amounts below, in inches.
Two Sided Mattress:
Label Side
Right: _______ Left: _______
Reverse Side
Right: _______ Left: _______
Foundation
Right: _______ Left: _______
Single Sided Mattress:
Label Side
Right: _______ Left: _______
Foundation
Right: _______ Left: _______
www.Beautyrest.com
www.Beautyrest.com
click to sign
signature
click to edit
Simmons Bedding Company Warranty Process Instructions
The following tags MUST be intact to validate your warranty claim:
Satin Trade Label “Under Penalty of Law” Tag
Non-flip Mattress Top Foundation Top Frame system
If your concerns are body impressions, place a straight edge (like a
yardstick or broom handle) across the area. Using a ruler, measure the
depth of the depressed area, without applying any pressure, and then
photograph the measurements. Please be sure to measure in the
middle of the quilted area, not the stitching.
Simmons Bedding Company Consumer Service customerassistance@simmonc.com
One Concourse Parkway, Suite 800 Atlanta, GA 30328 Toll-Free 877-399-9397 Fax: 770-613-8575 www.simmons.com
Dear Customer:
Thank you for contacting us about your dissatisfaction with your Simmons product. We are anxious to
assist you with your warranty claim. To ensure a prompt response and validate your warranty claim
please return the following items within 15 days. Include your claim number on all photographs.
If the claim form is not fully completed, including photographs, we cannot process your claim.
___ Completed Warranty Claim Request form (both sides)
___ Copy of your bill of sale, proof of purchase or proof of delivery (if available)
___ Photograph of the satin trade label and white “Under Penalty of Law” tag from the mattress
___ Photographs of the entire top surface and bottom surface of the mattress without linens.
(If the product is a non-flip, only pictures of the top surface are necessary)
___ Photographs of the impressions with measurements (if applicable)*
___ Photographs of the entire top surface of the box springs/foundation
___ Photograph of the entire frame structure
___ Photographs of any other concerns which need to be documented
* If your concerns are regarding body impressions which may have formed, place a straight edge
(yardstick or broom handle) across the area. Use a ruler to measure the depth of the depressed area,
photograph the measurements and record this information on the applicable area of the questionnaire.
Be sure to measure on the top of the quilt pattern, not the stitch channel, and do not apply any pressure.
See included instruction sheet for picture examples. Please DO NOT FAX PICTURES as they will
come out black and therefore delay your claim in processing.
After evaluating your questionnaire and photographs, we will notify you in writing of our findings.
Please do not dispose of your bedding product until your claim is finalized by Simmons. If you have
any questions, please feel free to contact us, toll-free, at 877-399-9397.
To expedite service, you may fax your claim form to 770-613-8575 (do not fax pictures) or email to
claims@simmons.com. Emails must be under 2MB total to be received by our department. Our
mailing address is: One Concourse Parkway Suite 800 Atlanta, GA 30328.
Sincerely,
Simmons Corporate Warranty Department
2451 Industry Avenue | Doraville, GA 30360 | 877.399.9397 | claims@simmons.com | www.Beautyrest.com
To expedite service, you may email your claim form to claims@sertasimmons.com. Emails must be under total to
be received by our department. Our mailing address is: 2451 Industry Avenue Doraville, GA 30360.
Sincerely,
Beautyrest Consumer Care Department
6MB
Oval Medallion
Satin Trade Label
Under Penalty of Law Tag
2451 Industry Avenue| Doraville, GA 30360 | 877.399.9397 | claims@simmons.com | www.Beautyrest.com
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CONSUMER SERVICE WARRANTY CLAIM REQUEST (City of Oakland)

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Completed 23 May 2022

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