shippingform

STONE ELECTRONICS
7928 Beverly Blvd. Los Angeles, California 90048
Phone No. 323-931-2838 Fax 323-931-7116
Shipping Form

Fill in all the fields in the form below, sign and print.
Include this form in the shipment.

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I am sending you this shipment for the purpose of diagnosis and preparing an estimate of
repair. The shipping charges are to my account. I do not hold Stone Electronics liable
for any damage or claims to my equipment caused while shipping the item/s to Stone
Electronics and from Stone Electronics. Item/s are being shipped with adequate
insurance coverage.

(Please sign this form and include it in the shipment.)

_______________________ Date _______________________

Signature:


*Your Full Name:*



*Your E-mail Address:*



*Your Phone Number:*



*Street Address 1*



*City, State, Zip Code*



*Type of Equipment*



*Brand*



*Model*



*Serial Number*



*Purchase Date*



*Description of Problem:*