Crown 3, 2, 1 manual Visa MasterCard C.O.D, Cash/Check, Card Number Exp. Date

Detach and send with unit.

Crown Factory Service Information

Shipping Address: Crown International, Inc., Factory Service, Plant 2 SW, 1718 W. Mishawaka Rd., Elkhart, IN 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.)

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Other equipment in your system: _________________________________________________________

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