Crown Factory Service Information, Visa, Signature

Micro-Tech Series Power Amplifiers

Crown Factory Service Information

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

Phone: 1-800-342-6939 or 1-574-294-8200 Fax: 1-574-294-8124

Owner’s Name : __________________________________________________________________________________________________________________________________________________________________

Shipping Address: ________________________________________________________________________________________________________________________________________________________________

Phone Number: ________________________________Fax Number: ________________________________ Email __________________________________________________________________________________

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.)

_______________________________________________________________________________________________________________________________________________________________________________

Other equipment in system: ________________________________________________________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________________________________________________________

If warranty has expired, payment will be: ! Cash/Check	! Visa	! Master Card	! C.O.D.	! Purchase Order for Crown Dealer
Card Number:___________________________________ Exp. Date:___________________
Signature:______________________________________________________________________
		ENCLOSE THIS PORTION WITH THE UNIT. DO NOT MAIL SEPARATELY.
Operation Manual				page 27

Crown Audio 1201, 2401 Crown Factory Service Information, Visa, Purchase Order for Crown Dealer

Models: MT-601 1201, 2401

Micro-Tech Series Power Amplifiers

Crown Factory Service Information

NATURE OF PROBLEM

! Visa

! Purchase Order for Crown Dealer

Card Number:_________________ Exp. Date:_

Signature:______________________________________________________________________

Micro-Tech Series Power Amplifiers

Crown Factory Service Information

NATURE OF PROBLEM

! Visa

! Purchase Order for Crown Dealer

Card Number:___________________________________ Exp. Date:___________________

Signature:______________________________________________________________________

Card Number:_________________ Exp. Date:_