7049 Valjean Ave.              Tel: 818-785-8085
Van Nuys, California 91406        Fax: 818-782-5939

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Shipping Form
  1. Please fill out, print this form and attach it to your unit before shipping.
  2. Company Name
    Please type your company name.
  3. Last Name(*)
    Please type your last name.
  4. First Name(*)
    Please type your first name.
  5. E-mail(*)
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  6. Cell Phone Number(*)
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  7. Home phone
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  8. Work Phone
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  9. Address(*)
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  10. City(*)
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  11. State
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  12. Zip Code(*)
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  13. Country
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  14. Today's date(*)
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  15. Unit Information
  16. Model Number
    Please type the model number of your unit.
  17. Serial Number(*)
    Please type the serial number of your unit.
  18. Vehicle Make & Model
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  19. Vehicle Year
    Please type the year of your vehicle.
  20. Problem Description or Comment(*)
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  21.   Please print the form before submission.
  23. Ship to:

    Hi-Tech Electronic services
    7049 Valjean Ave.       Van Nuys, CA 91406
    Tel:(818)785-8085    Fax:(818)782-5939

    Email: service@hitechserv.com