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Pinnaclemicro Repairs by Fax

Before shipping us a drive for repair, please fill out the following form as completely as possible and then fax it back to us at 714-662-6859
After we get the below form from you we then will fax it back to you with a repair authorization number and have you ship the unit in to us for repair..

Piinnaclemicro
3400 W MacArthur Blvd. E
Santa Ana, CA 92704
http://www.pinnaclemicro.com
Email Address ?__________________________________

How did you find us ?__________________________

DATE:_______________________ Repair Number (Filled in by Pinnacle): __________________ 

BILL TO:Company:_____________________________________CONTACT:__________________________________
Street Address: ____________________________________________________________________________________
City, State, Zip:_____________________________________________________________________________________

**BLIND SHIP** Yes or No

SHIP TO:Company:_________________________________CONTACT:_________________________________
Street address:_________________________________________________________________________________
City, State, Zip: ________________________________________________________________________________
Buyer Contact:_____________________Phone#:________________ext.________Fax#:____________________
Technical Contact:________________Phone#:__________________ext._______Fax#:_____________________

MFG Model Serial Number Problem OS-B/U Software Amount Warranty
           
           
           
           
           

Paid Repair:______ Bench Fee:_______________ Turn Around Time:______________________

Terms:_______  PO#____________    Credit Card#:___________________________Exp:_____Holder Name:_________________________

Shipping Method :________ 

COMMENTS:__________________________________________________________
____________________________________________________________________