florida electronics services inc.
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Please describe your unit and the problem(s) with it:

Warranty Repair Non-Warranty Repair
   
Manufacturer*:
Model*:
Serial Number*:
Acc:

Brief Description
of problem:

Customer information:

Name*:
Phone Number*:
Fax Number:
Email:
Shipping Address*:
Comments:
   

Advance
Authorization Amount:
(what's this?)

 $ .00
 

Notes:

  1. Fields that are marked with (*) are required to submit this form.
  2. Please read our Shipping Disclosures and Policies.
  3. We require a non-refundable Diagnostic fee of $80.00.
  4. You should receive a response within 1 or 2 business days if you have provided a phone number, fax number or an email address. Standard US Postal Service responses could require as much as 10 days to reach you.
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