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Customer's Contact Information
Title★
Mr. Ms.
First name★
Last Name★
Company
Email
Address★
No. Street Barangay City / Province
Phone Number★
Please fill up at least one phone number.
Telephone  
Cellphone  

Unit Installation Information
Name of installer / Service center
Type
ex. Residential, Office, Factory, etc.
Where the air conditioner installed
No. Street Barangay City / Province
Date Installed
Day Month Year

Unit Information
Model
Dealer / Store Name
Date purchased★
Day Month Year
Dearler / Store location
Invoice/o.r #
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