Repairs by Utilitronics Repair Form | Shipping Form
UTILITRONICS CORP.  
     P.O. Box 1616  Plainville, MA 02762  Ph 800-245-8850  Fx 508-809-6249


REPAIR FORM

Please provide us with your billing and shipping information:

INVOICE TO:                                                  SHIP TO:

                                                         
                                                                                

                                                         
                                                                                

                                                         
                                                                                

                                                                                                                                          

ATTN:                                                                ATTN:                                                  

PHONE NO.:                                                     FAX NO.:                                                  

P.O. #                                    AUTHORIZED BY:                                    DATE:                  Please note new batteries may be replaced at our shops discretion and old batteries our disposed of unless stated otherwize.
RETURNING FOR REPAIR:              PLEASE DESCRIBE PROBLEMS:
MODEL:                                                                                                                                        
CHECK ITEMS BEING RETURNED:                                                                                          
                                                                                                                                                       
          RECEIVER                SERIAL#                                                                                            
        
  TRANSMITTER        SERIAL#                                                                                           
        
  METROCLAMP                                                                                                                   
        
  CONDUCTIVE ATTACHMENT                                                                                         
        
  CASE                                                                                                                                    
        
  OTHER, PLEASE SPECIFY:                                                                                                


PLEASE SHIP TO:

UTILITRONICS
ATTN:  SERVICE DEPT.
2 HIGH STREET
PLAINVILLE, MA 02762

                                                                                 CUT OUT AND TAPE TO BOX