logo Loaner Form
    Please fill this form out carefully. You may bring printed form to any of our Virginia Stores along with the vacuum that you would like us repair.

    Important: We will need at least 2 forms of identification to provide you a loaner
    Vacuums Unlimited
    11217C Lee Highway
    Fairfax VA 22030
    (Next to Chili's Retaurant Corner 
    of Lee Highway and Germantown Road)


    Vacuums Unlimited
    474 Elden Street
    Herndon VA 20170
    (In K-mart Shopping Center)

    Vacuums Unlimited
    171 Maple Ave. East
    Vienna, VA 22180
    (Next to Fresh Fields Supermarket Corner of Maple Avenue and Park Street)
    Vacuums Unlimited
    201 Davis Dr. Unit C
    Sterling VA 20164
    (opp. Chevron/Sweet ater Carwash)

    City: State:
    Zip: Home Phone:
    Work Phone: Fax:
    Brand of Vacuum: Model# (if known) :
    Serial# (if known) :
    Problem with vacuum:
    How old is the vacuum?
    Additional Comments:
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