Whelen Repair Form

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MASS NOTIFICATION PRODUCTS
RETURN FOR REPAIR FORM
No RMA is Required
Please complete a copy of this form for each module and attach it to the unit.
Date: _________________ Purchase Order Number: _______________
Billing address:
Shipping Address:
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
Name of equipment end user: _________________________________
Contact person: __________________ E-Mail: ___________________
Telephone: (____) ________________ Fax: (____) ________________
Unit part number: ________________ Serial Number: _____________
Detailed description of the problem experienced with this unit:
______________________________________________
______________________________________________
______________________________________________
______________________________________________
(If returning a radio, please include the interface board)
(Please pack heavy items separately)
Ship Repairs To: Whelen Engineering Company
Attn: Public Warning Service Department
51 Winthrop Road
Chester, CT 06412
12212016
51 WINTHROP ROAD, CHESTER, CT, USA 06412-0684
TELEPHONE: (860) 526-9504 FAX: (860) 526-4784

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