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Form 0130M 03/29/07
Superchips Inc
.
Superchips Inc.
1790 East Airport Blvd., Sanford, FL. 32773 (407) 585-7000 http://www.Superchips.com
Superchip & Superchips are registered trademarks of Superchips, Inc.
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Form 0130M 03/29/07
Superchips Inc
.
Superchips Inc.
1790 East Airport Blvd., Sanford, FL. 32773 (407) 585-7000 http://www.Superchips.com
Superchip & Superchips are registered trademarks of Superchips, Inc.
If it is necessary to return your Microtuner to Superchips, please take a moment and fill out this
form. the following information will be necessary to process your request.
Check list:
Complete this form and have it available when you contact Superchips.
Contact Superchips Customer Service @ 407.585.7000 to obtain an RA number.
If an RA number has been issued, enter the RA number on the bottom of this form.
Attach a photocopy of your purchase receipt to this form.
Attach this form to the product being returned to Superchips.
Name:______________________________________________
Street Address: _______________________________________
City: _______________________ State: _______ Zip: _________
Home Phone:__________________ Other phone: _______________
Place of purchase: _____________________________________
Date of Purchase: _______________________
Vehicle Year: _____ Vehicle Make: ___________
Vehicle Model: ______________________
VIN Number: ______________________________________
Transmission:
Automatic
Manual
Tuner model: _____________________
Serial number on back of Microtuner: ______________________
E-mail address: _____________________________________________________
RA Number:_________________
Prior to returning any product to
Superchips
, you must obtain an
RA number; please contact
Superchips
customer service at
407.585.7000.
Please attach a photocopy of sales receipt here.
