MONITOR DEPOT, INC         

5359 West Richey Road  Houston,  Texas  77066    

CALL:  (281) 580 - 5656     After Hours  (281)  450 - 1064    

 

FLAT PANEL MONITOR REPAIR FORM

Note:  Print this form and then complete by hand.

STEP 1:  Ship to Information:      

Name:   _________________________________________________________

Attn:   ___________________________________________________________

Street:___________________________________________________________

City: ____________________________, St __________ Zip_______________

Check:          Residential              OR        Commercial       Address

Tel:  ( ____ )    ______    -    _______    

 E-mail:______________________________________________  (print clearly)

Unit Brand & Model #        ____________________________________________

SN:    ________________________________   Send in the Power supply if it has one.

Problem  description:   ______________________________________________

_________________________________________________________________

INPUT USED:   TV    Computer    DVI     S Video    Other___________

RMA #   issued     ______________  

Insurance value you would like for return shipping   $   _____________

 

You can use the following shipping for a shipping label to us if desired: 

 

             Ship to:     MONITOR DEPOT, INC

                   5359 WEST RICHEY ROAD

                   HOUSTON, TX    77066

                               

                                   RMA  #  ___________________