Restonic Warranty Claim Contact InformationFirst Name*Last Name*Street AddressCityStateZipEmail Address*Email Address Confirm*PhoneHow do you prefer to be contacted?PhoneEmailPurchase InformationStore NameStore Location (City, State)Do you have your original store receipt and law tag?*YesNoPurchase Day12345678910111213141516171819202122232425262728293031Purchase MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberPurchase Year20212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990Product InformationMattress Model Name*Mattress Model # (located on label)Mattress Size*TwinDoubleQueenKingCalifornia KingWhat did you purchase?Box SpringMattress OnlyBox Spring and MattressBed Frame SupportWooden Slat BaseAdjustable BasePlatform BaseSteel Frame BaseQueen and King size bedding requires a metal frame (or bed base) with rigid center support as outlined in our warranty policy.If using a wooden slat or steel frame base, is there a rigid center support?YesNoFactory Location (Found on Law Tag)*Select A FactoryCaliforniaFloridaIndianaIowaKansasMichiganMissouriNew YorkNorth CarolinaNorth DakotaOregonTennesseeTexasUtahOtherPlease consult your law tag for factory information. If you do not have your law tag, your claim will be received but cannot be processed.Is your mattress free from soils/stains?*YesNoHow many legs are on your bed frame?*FourFiveSixNineClaim ExplanationPlease explain your warranty claim