VEXILAR SERVICE SHIPPING FORM

VEXILAR SERVICE SHIPPING FORM
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Model Number:
Serial Number
Age of Unit
Have You Registered This Unit for Warranty?*

YesNo
Please Describe the Issue and the Problem with the Unit*
Upload Image to Show Problem (optional)

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You will receive a copy of this form via email. Please include printed copy inside the package along with the unit that you are shipping in for service. Send to:

Vexilar, LLC. Attn: “Service”
6667 West Old Shakopee Rd, Suite 101
Minneapolis, MN 55438
Should be Empty: