Landice L Series Diagnostic And Service Manual page 15

0
111 Canfield Avenue
DEALER INFORMATION:
Service Dealer / Dealer Name:
Address
City
Phone( )
Contact
CUSTOMER INFORMATION
Name
Address
City
Phone( )
TREADMILL INFORMATION
Model Type:
Frame Serial #
DCP Serial # (if applicable)
Out of box problem
CUSTOMER COMPLAINT
SERVICES PREFORMED/PARTS REPLACED
TRAVEL / LABOR: Travel Time:
VALIDATION SIGNATURES
Service Rep. Signature
PLEASE SUBMIT SERVICE CLAIMS VIA U.S. MAIL OR BY FAX.
DO NOT INCLUDE SERVICE CLAIMS WITH RETURNED WARRANTY PARTS.
DO NOT SUBMIT SERVICE CLAIMS WITHOUT SERVICE AUTHORIZATION NUMBER
•
Randolph, New Jersey 07869
SERVICE CLAIM FORM
Yes
Customer Signature
•
1-800-LANDICE
SA#
State
State
Contact
Date of Service
Date of Purchase
No
Labor Time:
_________
•
FAX 973-927-0630
Zip
Zip
TOTAL TIME:
15
Date