NOTICE: You MUST call Diamondback Fitness and obtain a DB Authorization Number PRIOR
to performing service. ANY FORM SUBMITTED INCOMPLETE WILL BE REFUSED.
DB Authorization Number:
Dealer's Information: (Please Print Clearly)
Account Name:
Account Number:
Address:
Phone Number:
Facility's / Consumer's Information that Received Service:
Name:
Address:
Phone Number:
Unit Information:
Model Repaired (i.e.: 500Ub ):
Serial Number:
Description of Problem:
Repair Performed:
FAX COMPLETED FORM TO 1-800-395-9548
Labor Credit Form
Date of Repair:
Technician's Name:
Fax Number:
Contact:
Date Unit Purchased:
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