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PLEASE COMPLETE THE FOLLOWING;
PLEASE NOTE: P. O. BOXES ARE NOT ACCEPTABLE
WARRANTY REPAIR / REPLACEMENT FORM
NAME:
DAY TIME PHONE NUMBER:
ZIPCODESTATECITY:
STREET ADDRESS:
CARD HOLDER NAME
(IF DIFFERENT FROM ABOVE)
LABOR, S/H CHARGE $ 19.95
LOCAL SALES TAX $
TOTAL PAYMENT $
(FOR PRODUCT MORE THAN 90 DAYS, BUT LESS
THAN 365 DAYS FROM RETAIL PURCHASE)
METHOD OF PAYMENT
CHECK OR MONEY ORDER ENCLOSED
REASON FOR RETURN
BE SURE TO ENCLOSE COMPLETED FORM, A COPY OF YOUR BILL OF SALE, PAYMENT (IF APPLI-
CABLE), SUPPLIED ACCESSORIES, TOGETHER WITH THE PRODUCT AND RETURN TO THE JVC
REPAIR/REPLACEMENT FACILITY NEAREST YOU.
TO OBTAIN THE ADDRESS OF THE LOCATION NEAREST YOU <PLEASE CALL (800) 252-5722 OR
VISIT OUR WEBSITE AT
HTTP://WWW.JVC.COM
CARD HOLDER SIGNATURE
BT-51025-2
(0103)
PRINTED IN CHINA
CREDIT CARD
VISA
MASTERCARD
DISCOVER
ACCOUNT NUMBER
EXP. DATE
04_WARRANTY_RC-EX30B_J.p65 04.4.12, 3:56 PM1