Laundry and Food Spoilage Claim Forms Food Spoilage Claim Form (Please Print and provide as much information as possible) GSP ID/Contract Number: _________________________________________ Service Work Order Number: _________________________________________ Name: ______________________________________________________ Phone Number: _______________________ Address 1: __________________________________________________________ Address 2: __________________________________________________________ City: _________________________________ State: _______ Zip: ______________ Product Brand & Model Number: _________________________________________ Spoiled Food Items 1. ___________________________ 2. ___________________________ 3. ___________________________ 4. ___________________________ 5. ___________________________ 6. ___________________________ 7. ___________________________ 8. ___________________________ 9. ___________________________ 10. ___________________________ 11. ___________________________ 12. ___________________________ 13. ___________________________ 14. ___________________________ 15. ___________________________ 16. ___________________________ 17. ___________________________ 18. ___________________________ 19. ___________________________ 20. ___________________________ Grand Total $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ 21. ___________________________ 22. ___________________________ 23. ___________________________ 24. ___________________________ 25. ___________________________ 26. ___________________________ 27. ___________________________ 28. ___________________________ 29. ___________________________ 30. ___________________________ 31. ___________________________ 32. ___________________________ 33. ___________________________ 34. ___________________________ 35. ___________________________ 36. ___________________________ 37. ___________________________ 38. ___________________________ 39. ___________________________ 40. ___________________________ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $ _______ $________________ Along with this form please include copies of the work order and original Best Buy sales receipt and either: Fax to: 952-430-7852 Email to: Reimbursement@bestbuy.com Or mail to: BEST BUY Attn: GSP Reimbursements - Floor C8 7601 Penn Ave South Richfield, MN 55423 The information in this document is copyrighted by Best Buy Co., Inc. and Geek Squad (updated 06/14) Laundry Credit Claim Form (Please Print and provide as much information as possible) Please note: Valid on laundry plans purchased between September 14, 2008 and July 5, 2014. The laundry product must be out for service for more than seven consecutive days in order to make a claim. GSP ID/Contract Number: _________________________________________ Service Work Order Number: _________________________________________ Name: ___________________________________________ Phone Number: ___________________ Address 1: __________________________________________ Address 2: __________________________________________ City: _______________________________________________ State: _______ Zip: ______________ Product Brand & Model Number: _________________________________________ Cleaning Service Company used: Cost of Services: 1. ____________________________________________________ $ ____________________ 2. ____________________________________________________ $ ____________________ 3. ____________________________________________________ $ ____________________ 4. ____________________________________________________ $ ____________________ 5. ____________________________________________________ $ ____________________ 6. ____________________________________________________ $ ____________________ 7. ____________________________________________________ $ ____________________ 8. ____________________________________________________ $ ____________________ 9. ____________________________________________________ $ ____________________ 10. ____________________________________________________ $ ____________________ Grand Total $________________ Along with this form please include copies of the work order and original Best Buy sales receipt and either: Fax to: 952-430-7852 Email to: Reimbursement@bestbuy.com Or mail to: BEST BUY Attn: GSP Reimbursements - Floor C8 7601 Penn Ave South Richfield, MN 55423 The information in this document is copyrighted by Best Buy Co., Inc. and Geek Squad (updated 06/14)