Repair Form

Boeckeler Product Repair

Instructions(follow in order):
1) Fill out the form
2) Print the form (and attach it to the unit)
3) Click the "Send" button to notify Boeckeler
4) Send the unit in a well-padded box
with the following on the label:

Repair Department
Boeckeler Instruments, Inc.
4650 S Butterfield Drive
Tucson, AZ 85714

Contact Information

Name

Company/Org

Phone

Required

Your Ship To:
Name
Address
City
State
Zip/Country Code
Country

Your Bill To:

Product Information:

Product

Out of Warranty In Warranty

Serial #

Problem

Other Notes
and
Payment Instructions

Click "Send" only after you've printed the form. "Reset" clears the form.

Print this form and send it with the unit to be repaired to:		Questions? Phone:
	Repair Department Boeckeler Instruments, Inc. 4650 S Butterfield Drive Tucson, AZ 85714		800-552-2262 or 520-745-0001 520-745-0004 (Fax)