1806 West Pinhook Road · Lafayette, LA  70508

Toll Free: 1.800.962.6355 · Phone: 337.232.1663

Fax: 337.856.8488 · www.powercontrolservices.com

Customer Information/Ship From: Ship To:
Company Name:
  Power Control Services
Contact Name:
  1806 West Pinhook Road
Address Line 1:
  Lafayette, LA  70508
Address Line 2:
  Attn: Repair Department
City, State, Zip:
  1-800-962-6355
Phone:
  PO #:
Fax:
  Repair Service:
Email:
 
Standard Rush
Qty.
Part Number
Manufactorer/
Descritpion
Problem with Unit
Unit Repair Price
Total Cost

Other Instructions:

Directions:

  1. Fill out form and attach to shipping box as a Packing Slip
  2. Ship to the above Shipping Address.
  3. Package items using Common Carried shipping guidelines.  For the safety of your equipment, if possible, insure items for
    replacement value or 4 times the estimated repair price.
  4. When your items are received, we will log them into our tracking system and contact you to let you know we have received them
    and at this time you will be able to track your items on line.