POCKETRAK EXCHANGE FORM
THIS FORM IS TO BE USED BY YAMAHA DEALERS ONLY.
PLEASE ATTACH THIS FORM ON TOP OF ANY OTHER DOCUMENTS
.
Ship-To address for return unit (Must be a street address that accepts UPS or FedEx delivery)
Dealer
Name:
_____________________________________________________
Street
Address:
____________________________________________________
Suite
#:
__________________________________________________________
City: ______________________________ State: ________ Zip: _____________
Your daytime phone number (8 AM - 5 PM Pacific time): ________________________
Detailed reason for return (use the back of this form if additional space is required):
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
POCKETRAK you are shipping to YAMAHA:
Model Number_____________________ Serial Number: __________________
Method of Payment, if applicable (check one):
Money order enclosed
Cashier’s check enclosed
Please bill my Yamaha Dealer Account #__________________(Net 30 Day Terms)
Authorized
Signature:
_______________________________________________
Print Your Name : __________________________________________________
For office use only:
Replacement: Y / N Model #_____________________
Charge Y / N Amount $_________________________
Warehouse: NIPNCA-A BP-B BP-A Reserved Stock Other:_____________
