General Repair/Refurbish 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.
For repair, send
projector only (no base). For ebay, send projector, condenser lens and
accessories.
but 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) _______________
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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: