Service Request Form
Owner information
Name/Company: ..............................................................................................................................
Shipping address:
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Country: ...........................................................................................................................................
Telephone: ........................................................... Fax: ...................................................................
Product information
Model: ..............................................................................................................................................
Serial number: .................................................................................................................................
Purchased from: ..............................................................................................................................
Purchase date: .................................................................................................................................
Problem description Be sure to explain the circumstances under which the problem occurred.
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Attempts to solve the problem
Send this service request form together with the unit to your authorised Q4audio dealer,
or to following address:
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Summit Engineering nv
Q4audio division
Tongersesteenweg 190
3800 Sint-Truiden Belgium
Tel: (+32) (0)11 69 42 59
Fax: (+32) (0)11 69 45 92
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