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Repair request form – Texas Instruments 3000 WinSX User Manual

Page 215

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Repair Request Form

Your name and address

Your Name

Company Name

Address

City State Zip Code

Phone number ( ) Ext.

Product serial number

Unit(s) you are returning (check where applicable)

q

TravelMate 3000 WinSX Computer

q

Expansion Station

q

2 MB RAM Module Kit

q

SCSI Adapter

q

Numeric Keypad

q

Ethernet LAN Adapter

q

80387SX Math Coprocessor

q

Internal Modem

q

AC Adapter

q

Internal Battery

Type of Claim

q

Warranty claim (attach proof of purchase)

q

Maintenance contract (Agreement No. )

q

My purchase order number

q

My check is enclosed.

q

Charge to my credit card.

q

MC

q

VISA

q

AMEX

Card Number

Exp. Date

Description of Problem (attach extra sheet if necessary)