AUTHORIZATION FOR CHARGE CARD TRANSACTION / TERMS OF PURCHASE



REPAIR ORDER FORM

Reach our repair department at (909) 980-2452 or repair@ for an RMA number or to discuss your needs.

Ship to: (UPS, FedEx, US Mail)

Whittemore Enterprises, Inc.

Attn: Repair Dept.

8250 White Oak Ave. Suite 102

Rancho Cucamonga, CA 91730

Be sure to properly package and insure your item(s) and include this form.

Customer information:

|Name/Facility | |

|Street Address | |

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|City | |

|State | |

|Zip | |

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|Contact name(s) | |

|Phone number(s) | |

|Fax number | |

|Email address | |

|Item |Model # |Serial # |Description of problem |

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|Any special instructions: |

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Whittemore Enterprises’ 90-day parts and labor warranty on repairs does not extend to powered equipment which has been improperly maintained, tampered with, altered or misused, maintained or operated contrary to the original manufacturer’s instructions, or repaired by the customer or a third party following Whittemore’s initial repair.

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