Crown Factory Service Information; Owner’s Name: _________________________________________________________________________; Shipping Address: ______________________________________________________________________- Page 33

Page 33

IQ–AMB-5 / IQ–SMX-6

 Reference Manual

AMB-5 / SMX-6

  IQ Mixer/Multiplexer

Detach and send with unit.

Crown Factory Service Information

Shipping Address: Crown International, Inc., Factory Service, Plant 2 SW, 1718 W. Mishawaka Rd., Elkhart, IN 46517

Phone: 1-800-342-6939 or 1-219-294-8200   Fax: 1-219-294-8124

Owner’s Name: _________________________________________________________________________

Shipping Address: ______________________________________________________________________

Phone Number: _____________________________

Fax Number: _____________________________

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.)

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Other equipment in your system: _________________________________________________________

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If warranty has expired, payment will be:

   ❏

   ❏

   ❏

   ❏

   ❏

 Cash/Check     

❏

❏

❏

❏

❏

 VISA     

❏

❏

❏

❏

❏

 MasterCard     

❏

❏

❏

❏

❏

 C.O.D.

Card Number:___________________________   Exp. Date:_______  Signature:____________________________

ENCLOSE THIS PORTION WITH THE UNIT. DO NOT MAIL SEPARATELY.