Printer Returned For Repair
Print this form on your local printer.  Fill it out and include it with the printer being returned.  Photostat a copy for your record of equipment returned to us for repairs.
You may also:  Save this form as a simple TEXT file, fill out the form on your computer and email the text file to acenteno@digi-trax.com
Ship your printer to:
Digi-Trax Corporation attn:  Repair Services
650 Heathrow Drive
Lincolnshire, IL 60069

Manufacturer: _______________ Model: _______________  Serial No.: __________________

Your Name: _________________ Phone: _______________ Ext.: _______________

Failure Description: _____________________________________________________________

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Return Shipping Information:

Attention: ___________________________ Company Name: ___________________________

Address #1: _________________________  Address #2: ______________________________

City: _______________________________ State: ___________ Zip: ____________________

Return Shipping Method:

Ground: ____  2nd Day Air: ____  Next Day Air: ____  My Carrier: _______________________
Air Bill Number: ______________________________

Insure Return Shipment?  Insure Amount:  $__________

Billing Information:

Company P.O No.: _______________________  Repair Limit: $________________

Attention: ___________________________ Company Name: ___________________________

Address #1: _________________________  Address #2: ______________________________

City: _______________________________ State: ___________ Zip: ____________________

Special Instructions: ___________________________________________________________

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