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Radio Repair Form
Radio Research Inc.
220 Finley Ave,
Staten Island, NY 10306
Phone: +1 718-980-6787, [email protected]
Please
make copy and attach one form per radio
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Radio serial number
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Radio model number
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Accessories
included with radio: (check all that apply)
Please
include accessories if they are
only connected with problem of the
radio.
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Battery
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Belt
Clip
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Headset
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Carrying Case
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Antenna
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Charger
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Microphone
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Other_______
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Description
of radio problem: (check all that apply)
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No Transmit
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No Receive
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Dead
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Liquid Damage
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Poor Transmit
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Poor Receive
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Physical Damage
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Other________
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Accessories
need to be added with radio after repair: (check all that apply)
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Battery
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Belt
Clip
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Headset
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Carrying Case
|
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Antenna
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Charger
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Microphone
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Other ______
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Party
responsible for radio equipment:
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eMail address:
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Phone
#
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Fax # :
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Payment information:
Check/MO Bill my PayPal account
__________________________________
Visa/MasterCard_____________________________________
Exp. Date_______
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