Tesla TIMV3500 GPU-24 - Repair Request Form

TI3500 GPU-24
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Repair Request Form
Please complete the information below to ensure prompt and accurate service. Include this form with the unit you are returning.
Thank you.
Date of return: ________________________
Company name & ____________________________________________________________________
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Billing address: ____________________________________________________________________
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Contact person: ________________________________________________________________________________
Phone #: _____________________________________ Fax #: ______________________________________
Email: _______________________________________________________________________________________
Purchase Order #: ______________________________________________________________________________
Model #: ____________________________________ Serial #: ________________________________________
Model #: ____________________________________ Serial #: ________________________________________
Shipping method to Tesla™: ______________________________________________________________________
Description of shipping package: ________________________________________________________________
Description of problem: _________________________________________________________________________
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Return to Tesla™ Industries, Inc.
101 Centerpoint Boulevard, New Castle, DE 19720 Attention: Repair Department