PREFERRED TELECOMM.  -  REPAIR ORDER FORM

Please print out this form, fill it out and include it with your cordless repair order.

COMPANY NAME ____________________________________________________

YOUR NAME ____________________________________________________

YOUR ADDRESS ____________________________________________________________________________

YOUR PHONE #______________________________    YOUR EMAIL ___________________

WHAT ARE YOU SENDING US? ___________________________________________________________

WHAT ARE THE SYMPTOMS IT'S EXHIBITING? _______________________________________

________________________________________________________________________________________

________________________________________________________________________________________

IS THIS PROBLEM INTERMITTENT?  YES___   NO___

IS THIS PROBLEM DELAYED? YES___   NO___

SEND THIS FORM WITH YOUR EQUIPMENT AND A CHECK FOR $25.00 FOR EACH* HANDSET OR EACH* BASE STATION made out to "PREFERRED TELECOMM"

*Note: if you're sending in a base station and a handset as a total system, you need only send $25.00. However, add $25.00 for each additional handset. Remember, this $25.00 goes towards the final repair bill.

Send to: PREFERRED TELECOMM   2275 LACROSSE AVE #204   COLTON, CA 92324

THANK YOU!