MOTOROLA, INC.
COMMUNICATIONS SECTOR
TEST EQUIPMENT SERVICE CENTER EAST
1313 EAST ALGONQUIN ROAD
SCHAUMBURG, ILLINOIS 60196
TEST EQUIPMENT SERVICE CENTER WEST
2333 B. Utah Avenue, El Segundo, CA
TEST EQUIPMENT SERVICE REQUEST FORM
This completed form must accompany equipment returned
for service.
CUSTOMER'S PURCHASE ORDER NO.
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DATE
MODEL NUMBER
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SERIAL NUMBER
DESCRIPTION OF PROBLEM:
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REQUESTED SERVICE:
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SHIP TO ADDRESS:
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SHIP VIA:
1
Providing the information below will reduce the turnaround time on your Test
Equipment Service.
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MOTOROLA CUSTOMER NUMBER
BILL TAG
SHIP TAG
INTERNAL MOTOROLA ACCOUNT NO.
SIGNED: _ _ _ _ _ _ _ _ _ _ _