Crown Factory Service Information Form - Crown CTS4200 Operation Manual

CTs Multi-Channel Power Amplifi ers
SRA #: __________________(If sending product to Crown factory service.)
Individual or Business Name: ______________________________________________________________________________________________________________________________________________________
_____________________
Phone #: __________________________________________________
______
Street Address (please, no P.O. Boxes): _______________________________________________________________________________________________________________________________________________
____________________________
City: __________________________________________
Nature of problem: _____________________________________________________________________________________________________________________________________________________________
______________
___________________________________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________________________________
Other equipment in your system: ___________________________________________________________________________________________________________________________________________________
________________________
If warranty is expired, please provide method of payment. Proof of purchase may be required to validate warranty.
I have open account payment terms. Purchase order required. PO#____________________________________________________
Credit Card (Information below is required; however if you do not want to provide this information at this time, we will contact you for the information when your unit is repaired).
Credit card information:
Type of credit card: Master Card
Type of credit card account: Personal/Consumer
Card # ______________________________________________ Exp. date: _____________ * Card ID #: __________________________
* Card ID # is located on the back of the card following the credit card #, in the signature area. On American Express, it may be located on the front of the card. This number is required to process the charge to your account. If you do not want to
provide it at this time, we will call you to obtain this number when the repair of your unit is complete.
Name on credit card: ____________________________________________________________________________
Billing address of credit card: __________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Operation Manual
Crown Audio Factory Service Information
Shipping Address: Crown Audio Factory Service, 1718 W. Mishawaka Rd., Elkhart, IN 46517
PLEASE PRINT CLEARLY
Model: _________________________________
PRODUCT RETURN INFORMATION
Fax #: ________________________________________
State/Prov: ________________________________
Visa American Express Discover
Business/Corporate
Serial Number: _____________________
Postal Code: _________________
PAYMENT OPTIONS
COD
Purchase Date: ________________
E-Mail: ___________________________________________________
Country: _____________________
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