STONE ELECTRONICS
7928 Beverly Blvd. Los Angeles, California 90048
Phone No. 323-931-2838  Fax 323-931-7116
Shipping Form
Fill in all the fields in the form below, sign and print.
Include  this form in the shipment.
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I am sending you this shipment for the purpose of diagnosis and preparing an estimate of
repair.  The shipping charges are to my account.  I do not hold Stone Electronics liable
for any damage or claims to my equipment caused while shipping the item/s to Stone
Electronics and from Stone Electronics.   Item/s are being shipped with adequate
insurance coverage.


                                   (Please sign this form and include it in the shipment.)
_______________________  Date _______________________
Signature:
Your Full Name:
Your E-mail Address:
Your Phone Number:
Street Address 1
City, State, Zip Code
Type of Equipment
Brand
Model
Serial Number
Purchase Date
Description of Problem: