Service Request Form
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1Service Request Form
Customer Section: This section to be filled out by the customer. All fields are required.
Date Sent:
RGA/Service Request Number:
(Required for In warranty Service;
Call # 800-953-5737 for Assistance)
Customer Name
Address (No PO Box Addresses)
Serial #:
Phone #
Email Address
Type of Trap: Defender _____
Liberty ______
Liberty Plus _______
Patriot _____
Independence ________
Executive ________ Other _____________
Date of Purchase:
Purchased from: (retailer name):
Did you call Mosquito Magnet for
technical support?
Yes or No
What is wrong with the trap?
Customer’s Signature: __________________________________________
Date: ______________
The remaining sections are to be completed by Certified Service Center representatives.
RECEIVING
Date Received:
Technician’s Name:
Contents
Cosmetics
Diagnostics
: (List primary failure first)
CO
Gas Leaks
Power
PSI
Open Circuit
Output
Voltage
Fan
Igniter
Thermistor
LED Harness
Parts Replaced:
Solenoid
Main PCB
Main Harness
Power Adaptor
Regulator
Battery
Igniter PCB
Is the trap passing diagnostics and operating normally when returning to customer? Yes___ No______
Technician’s Comments:
__________________________________________________________________________________________
__________________________________________________________________________________________
Technician’s Signature __________________________________ Date Repaired ______________________
Your signature represents that the above information is true. Return one copy to the customer and retain one copy for your
records. Woodstream Corporation reserves the right to request a copy at any time.
Mosquito Magnet® Service Request Form
Woodstream Corporation
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Parent category: Business