SHIP TO:

FACTORY RADIO SERVICE
9155 ARCHIBALD AVE.
STE 404
RANCHO CUCAMONGA, CA 91730

  COMPLETE SHIPPING FORM AND PRINT.
NAME
ADDRESS
CITY
STATE
ZIP
EMAIL
PHONE HOME CELL WK
STEREO MODEL SERIAL CODE
VEHICLE YEAR MAKE MODEL
DESCRIPTION OF DEFECT
CD's PRESENTLY STUCK IN PLAYER
PLEASE LIST CD's ON SHIPPING FORM, CD's ARE RETURNED WITH STEREO EQUIPMENT.)
DEALERS ONLY (PLEASE INCLUDE BUSINESS CARD)
RO/PO# EXTENDED WARRANTY CO.      
    CONTRACT NUMBER      
PRINT SHIPPING FORM, ENCLOSE WITH EQUIPMENT. YOU WILL BE EMAILED WHEN EQUIPMENT IS RECEIVED.
TECH/OFFICE USE ONLY
LOGIN DATE REPAIR DATE BRACKETS
*WHEN SENDING EQUIPMENT, PACKAGE WELL, USE THREE INCHES OF PADDING ON ALL SIDES. PLEASE INSURE YOUR ITEM AT YOUR ESTIMATED VALUE. WHEN REPAIR IS COMPLETE, YOU WILL BE CALLED FOR PAYMENT WITH A TOTAL INCLUDING RETURN SHIPPING CHARGES. WE STOCK PARTS FOR ALL KNOWN.
WHEN COMPLETED PLEASE PRINT THIS PAGE OUT AND MAIL TO THE ADDRESS AT THE TOP OF THE FORM. -THANK YOU