Digatron LLC, Repair Form

Please print, and send this completed form with your unit. We recommend keeping a copy of this form for your records.
**Please send in your leads with your instrument. They can often be the problem**

Name____________________________________________________________________________

Street Address_____________________________________________________________________

Address (cont.) ____________________________________________________________________

City______________________________________________________________________________

State/Province _____________________________________________________________________

Zip/Postal code_____________________________________________________________________

Country __________________________________________________________________________

Day Phone ( ) _____________________________________________________________________

Eve. Phone ( ) _____________________________________________________________________

Fax ( ) ___________________________________________________________________________

E-mail ___________________________________________________________________________

Website __________________________________________________________________________

Please list model number(s) (found on back of instrument) and serial number(s):

Model Number _______________________      Serial Number __________________________

Please describe fully the problem you are having with your instrument and / or the work you would like done to your instrument.

__________________________________________________________________________________________________
Per our policy, we will call you if the charges will be over $75.00 per instrument before repairs are made.
·  If you have called Digatron and received an RMA #, please enter it here: ___________

** NOTE: An RMA # is for returns for credit or replacement - NOT REPAIRS.

BILLING (If payment method is not selected, package will be automatically shipped back to you COD)

□ VISA           □ MasterCard        Card Number: __ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __

□ COD           □ Money Order      Exp Date: __ __ / __ __          *Security Code: __ __ __     

* Security code is located on the back of your card... It is typically a three digit number                                        

 Cardholder Name   ______________________________________

                                                           Address/Zip Code where credit card bill is received:

                                                             _______________________________________________________

                                                            _______________________________________________________

                                                            _______________________________________________________

Please send your repair to: IF YOU ARE OUTSIDE OF THE U.S., please call before sending in your instrument. 
Digatron                                                      
120 North Wall St.   Suite 300                              
Spokane, WA 99201                                                                             
(509) 467-3128
1-866-344- 2876( U.S. Only)