SERVICE REQUEST FORM Name(Required) First Email(Required) AddressCityStateZip CodePhone(Required)BrandBrand:BERTAZZONIBLOMBERGXO APPLIANCEModel(Required)Serial Number(Required)Dealer Purchased From(Required)Date(Required)Please ExplainFileAccepted file types: jpg, gif, png, pdf, heic, Max. file size: 64 MB.