Service Requests

Please complete the Product Service Repair/Return form. You will recieve an email shortly with your submission confirmation. Please print it and then return it to us along with the product.

A Clear Sound representative will contact you with an estimate before any work is done.

Customer Information

Company Name: *

Contact Person: *

First and Last Name

Phone: *

555-555-5555

Fax Number:

555-555-5555

Email: *

Billing Information

Billing Address: *

City: *

State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip: *

Shipping Information: * Yes, same as billing infoPlease ship to the address below

Please enter your shipping information below if it is different from your billing information.

Shipping Information

Please enter your shipping information if different from billing information.

Shipping Address:

City:

State: - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip:

Product Information

Manufacturer: *

Model Number:

Serial Number:

Quantity: *

Description of Problem:

Warranty Information

Warranty Service:

In-Warranty

Out-of-Warranty

If your purchase is In-Warranty a copy of your purchase receipt indicating you purchased your unit new and within the last year must be verified.

If your purchase is Out-of-Warranrty there is a $50 minimum charge.

Purchase Date:

Year20072008200920102011201220132014

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Purchase Receipt:

If your purchase is in warranty please upload your receipt indicating you purchased your unit new and within the last year.

Pre-approved Service Repair: Pre approved up to: $

For faster service pre-approve a repair amount.

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