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*1. Model Number:


This number is printed in bold numbers on the front page of your instruction booklet.

*2. Purchase Date:


MM/DD/YYYY Format

*3. Place of Purchase:

*4. Factory & IM Number:


This information is on a sticker
located on the product itself.
View Sample Sticker

*5. Enter the part numbers and quantity needed below:

The part number is found on the parts list page located below the picture and description of the part needed.
Use part number 9997 if the hardware bag is missing.
Use part number 9996 if the instruction manual is missing.

DO NOT USE THE BOARD LETTER AS A PART NUMBER.
Part 1 Quantity: Part Number: Reason:
Part 2 Quantity: Part Number: Reason:
Part 3 Quantity: Part Number: Reason:
Part 4 Quantity: Part Number: Reason:
Part 5 Quantity: Part Number: Reason:

6. Customer Information

*First Name:

*Last Name:

*Street Address 1:

Street Address 2:

*City:

*State:

*Zip Code:

*Telephone:

*Email Address:


*Enter the code:

**DHP Furniture cannot ship replacement boards to a Post Office box