Diamondback 500Ub - Labor Credit Form

9
Labor Credit Form
NOTICE: You MUST call Diamondback Fitness and obtain a DB Authorization Number PRIOR
to performing service. ANY FORM SUBMITTED INCOMPLETE WILL BE REFUSED.
DB Authorization Number: Date of Repair:
Dealer’s Information: (Please Print Clearly)
Account Name:
Account Number: Technician’s Name:
Address:
Phone Number: Fax Number:
Facility’s / Consumer’s Information that Received Service:
Name:
Address:
Phone Number: Contact:
Unit Information:
Model Repaired (i.e.: 500Ub ): Date Unit Purchased:
Serial Number:
Description of Problem:
Repair Performed:
FAX COMPLETED FORM TO 1-800-395-9548