JVC RC-EX30BJ Instructions Manual page 50

PLEASE COMPLETE THE FOLLOWING;
PLEASE NOTE: P. O. BOXES ARE NOT ACCEPTABLE
NAME:
STREET ADDRESS:
CITY:
DAY TIME PHONE NUMBER:
LABOR, S/H CHARGE
LOCAL SALES TAX
TOTAL PAYMENT
METHOD OF PAYMENT
CHECK OR MONEY ORDER ENCLOSED
CREDIT CARD
VISA
MASTERCARD
DISCOVER
CARD HOLDER NAME
(IF DIFFERENT FROM ABOVE)
REASON FOR RETURN
BE SURE TO ENCLOSE COMPLETED FORM, A COPY OF YOUR BILL OF SALE, PAYMENT (IF APPLI-
CABLE), SUPPLIED ACCESSORIES, TOGETHER WITH THE PRODUCT AND RETURN TO THE JVC
REPAIR/REPLACEMENT FACILITY NEAREST YOU.
TO OBTAIN THE ADDRESS OF THE LOCATION NEAREST YOU <PLEASE CALL (800) 252-5722 OR
VISIT OUR WEBSITE AT HTTP://WWW.JVC.COM
BT-51025-2
(0103)
WARRANTY REPAIR / REPLACEMENT FORM
STATE
$ 19.95
$
$
ACCOUNT NUMBER
(FOR PRODUCT MORE THAN 90 DAYS, BUT LESS
THAN 365 DAYS FROM RETAIL PURCHASE)
CARD HOLDER SIGNATURE
ZIPCODE
EXP. DATE
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