Repair Service Form

: Customer Information
Company Name:
Dealer Code:
Address:: Line 1:
Line 2:
City:
Country:
State:
Postal Code:
Contact Name:: First Name:
Last Name:
Phone Number:
Email Address:
Instrumentation: Instrumentation Clusters DIC HUD CRT
Part Number:
Item Description:
Vehicle Make:
Year:
Model:
Odometer:
Odometer (KM):
Odometer (M):
Vehicle V.I.N.:
: Audio Video or Other Products
Part / Model Number:
Serial Number:
Product Description:
Comments:
: Carefully pack your defective unit in a sturdy shipping container and ship it prepaid by courier to: Custone Electromotive Inc. 1150 Champlain Court, Whitby, ON L1N 6K9 *Att: Serv Dept. Print and include this completed form in the box. Custone will contact you with an estimate before repair.

call us
(905) 668 2668

Customer Information