Service Return Authorization Request
Shipping Address: HARMAN Factory Service, 1718 W. Mishawaka Rd., Elkhart, IN 46517
You may also request a service return authorization at www.crownaudio.com/support/rma
PLEASE PRINT CLEARLY
SRA #: _________________________________________________________________________________ (If sending product to Crown factory service)
Model: __________________________ Serial Number: ______________________________ Purchase Date: ________________________________________________________
PRODUCT RETURN INFORMATION
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.
PAYMENT OPTIONS
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:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
