All send in devices must contain this form inside the box to avoid any confusion as we receive packages daily.

Name :_____________________________________________________________________________________________

address: _____________________________________________________________________________________________
__________________________________________________________________________________________________________________________


phone: # ____________________________________________________________________________________________________________________________________________

email:_____________________________________________________________________________________________@____________________________________________________________


date:__________________/_____________________/_________________________

signature :_____________________________________________________________________________________________


SERVICE/REPAIR : ____________________________________________________________________________________________________
_____________________________________________________________________________________________

NOTES ;__________________________________________________________________________________________________________________________________________________________________________________________




PLEASE SHIP SECURELY AND USE TRACKING 5KMODS LLC, IS NOT RESPONSIBLE FOR LOST SHIPMENTS OR DAMAGED SUFFERED DURING TRANSIT TO OUR REPAIR CENTER.  PLEASE INCLUDE THIS FORM INSIDE YOUR MAILING BOX FOR FASTEST SERVICE!
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