Please print this page and include it with the repair or service request. Use your "Print Screen" function of your computer
[Windows ctrl+prt sc] buttons to print.
Service shipping address:
Custom CB Radios
722 W National Ave
Brazil In. 47804
Name______________________________________________________________________________________________________________
Phone_________________________________________________________________________________________________
Return Address__________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Requested Service_________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________