Contact Information
  Contact Name    Date   
  (Dealerships only) Dealer Name   RO#
  Address
  City State Zip -
  Work phone     Cell     Home
  Email

  Car Information
  Vehicle Make Model Year
  Car Stereo Information
  Stereo Model #  Serial # Theft code (Coded stereos only)
  Car Stereo Bose Amplifier Information
  # of Bose Amplifiers for repair ,    RF     RR     LF     LR     Center

  Description of defect
 
  Additional notes
 
  Did we correspond before you sent your equipment? email phone

Print form and enclose with equipment.

When sending equipment, use three inches of padding on all sides. If equipment is damaged due to shipping, and you have to submit a claim, the first question we are asked is "Was the equipment packaged properly?". Upon completion of repair, you are notified of repair cost plus return S&H. Please insure Bose Amplifiers for $500 and Car stereos for $1000+.
When repair is complete, you will be notified for MC or Visa with a total including return shipping charges.
Detach and enclose above portion with package and use mailing label below.

From

FACTORY CAR STEREO REPAIR, INC.
1987 Corporate Square Suite 159
Longwood, Fl. 32750