Yamaha POCKETRAK 2G Service Manual page 4

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THIS FORM IS TO BE USED BY YAMAHA DEALERS ONLY.

PLEASE ATTACH THIS FORM ON TOP OF ANY OTHER DOCUMENTS

Ship-To address for return unit (Must be a street address that accepts UPS or FedEx delivery)

Dealer Name: _____________________________________________________

Street Address: ____________________________________________________

Suite #: __________________________________________________________

City: ______________________________ State: ________ Zip: _____________

Your daytime phone number (8 AM - 5 PM Pacific time): ________________________

Detailed reason for return (use the back of this form if additional space is required):

_________________________________________________________________

POCKETRAK you are shipping to YAMAHA:

Model Number_____________________ Serial Number: __________________

Method of Payment, if applicable (check one):

Money order enclosed

Cashier's check enclosed

Please bill my Yamaha Dealer Account #__________________(Net 30 Day Terms)

Authorized Signature: _______________________________________________

Print Your Name : __________________________________________________

For office use only:

Replacement: Y / N Model #_____________________

Charge Y / N Amount $_________________________

Warehouse:

NIPNCA-A

POCKETRAK EXCHANGE FORM

BP-B

BP-A

Reserved Stock

Other:_____________

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