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Please complete the information below to ensure prompt and accurate service. Include this form with the unit you are returning.
Thank you.
Company name &
Billing address:
Contact person:
________________________________________________________________________________
Phone #:
_____________________________________
Email:
_______________________________________________________________________________________
Purchase Order #:
______________________________________________________________________________
Model #: ____________________________________
Model #: ____________________________________
Shipping method to Tesla™:
Description of shipping package:
Description of problem:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
101 Centerpoint Boulevard, New Castle, DE 19720 Attention: Repair Department
TI150 Series Hardwired Battery Charger/Conditioner
Repair Request Form
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
______________________________________________________________________
________________________________________________________________
_________________________________________________________________________
Return to Tesla™
Date of return: ________________________
Fax #:
______________________________________
Serial #:
________________________________________
Serial #:
________________________________________
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