UNIT REPAIR FORM (Include with Unit Shipped)

When you send an item for repair, please be sure to include the following information:
Name: ____________________________ Home Phone: _______________________
Work Phone: _______________________
Address: (Street) ________________________________________________________
City___________________________________________________________________
State: ______________________ Zipcode____________
Make _________________________ Model: ______________________
Serial No.: _____________________ Type: ___________________

DESCRIPTION OF PROBLEM: Describe in your words, give us as much information as possible.
_________________________________________________________________
_________________________________________________________________

Date Shipped:_____________________
Purchased from: ___________________ (Include a copy of Bill of Sale, if in warranty)
D.O.P. _____________ (Required only if Unit is in warranty)
Condition: ________________ (Please note any defects in appearance.
Any accessories (List)______________*

*PLEASE DO NOT SHIP YOUR HARNESS, AC CORD, ANY TAPES, OR CD’S, MAGAZINES, SLEEVE, BASKET, TRIM RING, REMOTE, OR CABLES. IF ANY ACCESSORY IS CAUSING A PROBLEM—BE SURE TO LIST UNDER ACCESSORIES ABOVE.