Crown Audio 180MA Product Return Information, Credit card information, Please Print Clearly, page

Models: 180MA 280MA

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Crown Audio Factory Service Information

Commercial Audio Series Mixer-Amplifiers

Crown Audio Factory Service Information

Shipping Address: Crown Audio Factory Service, 1718 W. Mishawaka Rd., Elkhart, IN 46517

PLEASE PRINT CLEARLY

SRA #: __________________(If sending product to Crown factory service.)Model: ____________________________________________ Serial Number: _____________________ Purchase Date: _____________

PRODUCT RETURN INFORMATION

Individual or Business Name: ____________________________________________________________________________________________________________________________________________________________

Phone #: __________________________________________________Fax #: ________________________________________E-Mail: _______________________________________________________

Street Address (please, no P.O. Boxes): _____________________________________________________________________________________________________________________________________________________

City: __________________________________________State/Prov: ________________________________Postal Code: _________________ Country: _________________________

Nature of problem: ___________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________

Other equipment in your system: _________________________________________________________________________________________________________________________________________________________

If warranty is expired, please provide method of payment. Proof of purchase may be required to validate warranty.

PAYMENT OPTIONS

I have open account payment terms. Purchase order required. PO#: __________________________________

COD

Credit Card (Information below is required; however if you do not want to provide this information at this time, we will contact you when your unit is repaired for the information.)

Credit card information:

Type of credit card:

Type of credit card account:

MasterCard

Personal/Consumer

Visa

Business/Corporate

American Express

Discover

Card # ______________________________________________ Exp. date: _____________ * Card ID #: __________________________

*Card ID # is located on the back of the card following the credit card #, in the signature area. On American Express, it may be located on the front of the card. This number is required to process the charge to your account. If you do not want to provide it at this time, we will call you to obtain this number when the repair of your unit is complete.

Name on credit card: ____________________________________________________________________________

Billing address of credit card: __________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Operation Manual

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Crown Audio 180MA Product Return Information, Credit card information, Crown Audio Factory Service Information, page