Complete all sections of this form where applicable and include a printed copy of the accepted page OR of the confirmation email you receive with the item being returned. A restocking fee may be applied for returned merchandise.

Unit Information

***Note: An incorrect or false Serial Number may result in the product being returned unrepaired.

Problem Description Information

***NOTE: If you are sending an item in for repair, please give a detailed description of the problem. Please list any special instructions that you may have concerning this return including if this is an intermittent issue or one that happens every time the product is used.

Calibration Requirement*

(Calibration of Radar requires all components available at the time of repair, except remote. Calibration fee does not include parts needing to be replaced.) The calibration fee per system is:



Address information

Bill To Address


Ship To Address -

Repair Authorization*


Purchase Order Required?


(If applicable, fax a copy of the Purchase Order to Customer Service at (270) 685-6288 or email to info@mphindustries.com)

Estimate Information*


Confirmation

Fill out the information below so we can send you a copy of this form.

Authorization

Please only click submit once.