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
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) |