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Print this form to send in with unit to : |
BC Electronics 2346 BRISTOL-OXFORD VALLEY RD LEVITTOWN, PA 19057-1305 |
Phone: 215-547-7600 |
For Original Equipment Car Product please provide the Year, Make & Model of the vehicle:
____________________________________________________________
Code needed for anti-theft radios only: Usually found in glove box (looks like a credit card). Code________________(3-5
digits)
Problem with unit_____________________________________________________________________________
___________________________________________________________________________________________
You are responsible for the packaging when shipping to us. You can insure your equipment for just a few dollars, but the best insurance is to be sure it is packaged correctly. Insurance won't pay if not correctly packaged. PACKAGING GUIDELINES
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THIS IS YOUR AGREEMENT FOR THE MINIMUM LABOR / DIAGNOSTIC CHARGE AND PAYMENT. I am aware there is a non-refundable minimum labor charge of $63.50 for a diagnosis / estimate on each unit sent in for repair. This Fee does not include return shipping ( based upon current FEDEX pricing ). Please circle one: ESTIMATE FIRST or OK TO REPAIR UP TO $_________ Signed ____________________________ Print Name as on card: ___________________________ Billing Address & Zipcode ( if different than above )______________________________________ Circle Credit Card Type: MasterCard - Visa - Discover - Amex Card # _____________________________ Exp __________ Security Code_________ Enclosed is my check / money order for $________ (personal checks - allow 14 days to clear) |