CineMate - LED - Motor Upgrade Form
Equipment shipped to physical addresses ONLY.
No Post Office boxes, please.
Please print neatly. This is the address that we will
be shipping your unit to.
Tape a copy of this
completed form to each item
BEFORE you
wrap or package in a box for shipping.
Failure to do so
may result in a delay on your repair or upgrade.
Send projector
only. Do not send base. Make sure large front cover is on unit.
If international,
declare a value of only $50 and mark "repair under warranty".
We will do the
same when we ship it back to you.
Equipment sent:__________________________________________________________________
Name:_________________________________ Company:_______________________________
Day phone:_________________________________(if international, please include country code)
Email address:___________________________@______________________________________
Street______________________________________________ Apartment or Suite #__________
City: ___________________________________ State/Province__________________________
Country _______________________________________ Postal Code (zip) _______________
Payment method: (please circle)
PayPal
Cashier's Check Company
Check Wire Transfer
Exact amount of payment, including shipping and any wire transfer
fees $__________________
Date payment sent:_____________ Date
payment received:___________________
(do not fill in)
NOTES: