First name*
 
 
 
 
Last name*
 
 
 
 
Phone*
 
 
 
 
E-mail*
 
 
 
 
Street + Number*
 
 
 
 
Postal code*
 
 
 
 
City*
 
 
 
 
Purchase date*
 
 
 
 
Product group*
 
 
 
 
Reference number appliance*
 
 
 
 
Serial number appliance*
 
 
 
 
At which Novy dealer did you purchase the appliance?*
 
 
 
 
In which city did you purchase the appliance?*
 
 
 
 
Problem description*
 
 
 
 
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