Service/Repair Submission Form

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Name of Person Shipping Unit for Repair (required)

Billing Address

Return Address

Daytime Phone

Cell Phone

Contact Email (required)

Is this a warranty repair?
Yes (Please provide copy of purchase receipt.)No (I authorize a minimum charge of $110.)

Payment Method
CheckMoney OrderCredit Card*Warranty Repair**
*Please call 800.924.9992 if paying by credit card.
**Please provide copy of purchase receipt if this is a warranty repair.

Nature of Problem


Serial Number (please enter "n/a" if not available)

When Does This Happen? (check all that apply)
All of the time.Some of the time.After it is turned on for a while.Not often.Each time it is turned on.Problem with the audioProblem with the video.Problem with both the audio and the video.Started recently after a storm.