Desert Aircraft DA100 Owner's Manual page 9

Table of Contents

Repair/Return Form

(Please make copy)

Please fill out and enclose this form when shipping items for service

Customer Name_________________________________ Date___________

Address________________________________________________________

City______________________ State______ Zip_________ Country________

Phone #_________________ Cell #__________________

Email _________________________

Items in Box:

DA50 Serial #__________ DA60 Serial #__________ DA85 Serial #__________

DA100 Serial #_________ DA120 Serial #_________ DA150 Serial #_________

DA170 Serial #_________ DA200 serial #_________ Other________________

Single Ignition Serial # ________

Twin Ignition Serial # ________

Prop Bolts? ___________

Prop washer? _________

Muffler(s)? ____________ Muffler screws_____________

Standoffs? ____________

Other Items? __________

REASON FOR RETURN?

Crash:

Yes___ No____

Other_________________________________________

_______________________________________________________________________

Oil used? _____________

Gas type? _____________

Exhaust system type? __________________

Has the engine been sent in for service before? _______Why?________________

______________________________________________________________________

DESERT AIRCRAFT

1815 S. Research Loop

Tucson, AZ 85710

520 722 0607

info@desertaircraft.com

www.desertaircraft.com

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