Service Request Intake Form

Current Date and Time of Submission *

Day, month, year

Time

Consumer/Customer K. Number (Account Identifier) *

Full Name of Requestor *

Mobile Contact Number *

Full Service Address (Street, City, Pincode) *

Preferred Time Slot for Service Call *

Morning (9:00 AM - 12:00 PM) Afternoon (1:00 PM - 4:00 PM) Evening (4:00 PM - 7:00 PM) Anytime

Total Number of AC Units Installed at this Location *

AC Brands and Quantities Add each brand you have and how many units of it. (Optional)

Is functional Wi-Fi available at the premises? *

Yes, Wi-Fi is available and working. No, Wi-Fi is not available.