Crown 1-vcap Guía Del Usuario

        Shipping Address: Crown Factory Service, 1718 W. Mishawaka Rd., Elkhart, IN 46517

SRA #:  __________________(If sending product to Crown factory service.)                  

Model: ______________ 

Serial Number:  _____________________         Purchase Date:  ____________ 

Individual or Business Name: _____________________________________________________________________ 
Phone #:  _____________________________________                Fax #: __________________________________ 
E-Mail:  _______________________________________ 

Street Address (please, no P.O. Boxes):  ____________________________________________________________ 
____________________________________________________________________________________________ 
City: _________________________________________________                    State/Prov: ____________________ 
Postal Code: _________________               Country:  _________________________ 

Nature of problem:  _____________________________________________________________________________ 
_____________________________________________________________________________________________
_______________________________________________________________________________________________________________________________ 

______________________________ 

_______________________________________________________________________________________________________________________________ 

_____________________________ 

Other equipment in your system:  _________________________________________________________________ 
____________________________________________________________________________________________ 

If warranty is expired, please provide method of payment. Proof of purchase may be required to validate warranty. 

     I have open account payment terms.  Purchase order required.  PO#:  ______________________              COD 

      Credit Card   (Information below is required; however if you do not want to provide this information at this time,  

we will contact you when your unit is repaired for the information.) 

 

                                 Credit card information: 

Type of credit card:        MasterCard                         Visa                              American Express                       Discover 

Type of credit card account:                 Personal/Consumer                          Business/Corporate  

Card # ____________________________ Exp. date: _____________    * Card ID #: _________________________ 

* Card ID # is located on the back of the card following the credit card #, in the signature area.  On American  

Express, it may be located on the front of the card. This number is required to process the charge to your account. 
If you do not want to provide  it at this time, we will call you to obtain this number when the repair of your unit is  
complete. 

Name on credit card: ____________________________________________________________ 
Billing address of credit card: __________________________________________ 

                                              __________________________________________ 
                                              __________________________________________ 
                                              __________________________________________