Crown Com-Tech CT-1610 - Page 19

R.S.V.P. Remote Switching Voltage Provider
Page 19
Crown Factory Service Information
Shipping Address: Crown International, Inc., Factory Service,
Plant 2 SW, 1718 W. Mishawaka Rd., Elkhart, IN U.S.A. 46517
Phone: 1-800-342-6939 or 1-219-294-8200 Fax: 1-219-294-8124
Owner’s Name:__________________________________________________________
Shipping Address: _______________________________________________________
Phone Number: _______________________ Fax Number: ___________________
Model: _______________________________ Serial Number: _________________
Purchase Date:__________________________________________________________
NATURE OF PROBLEM
(Be sure to describe the conditions that existed when the
problem occurred and what attempts were made to correct it.)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Other equipment in your system: __________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
If warranty has expired, payment will be:
❏❏
❏❏
❏ Cash/Check
❏❏
❏❏
❏ VISA
❏❏
❏❏
❏ MasterCard
❏❏
❏❏
❏ C.O.D.
Card Number:___________________________
Exp. Date: __________ Signature:____________________________
ENCLOSE THIS PORTION WITH THE UNIT.
DO NOT MAIL SEPARATELY.