Mountz, Inc.

Service Request Form

Ship to one of the Mountz Service Centers:

 Eastern Service Center
Contact: Kaylen Ewing
19051 Underwood Rd., Foley, AL 36535
Phone: (251) 943-4125
Fax: (251) 943-4979
 Western Service Center
Contact: James Bassett
1080 N. 11th Street, San Jose, CA 95112
Phone: (408) 207-4320
Fax: (408) 292-2733
 UK Service Center
Contact: Mawuli Austin
Pier Copse Courtyard, Milland Lane,  
Liphook, Hampshire, GU30 7JN, UK
Phone: 00 44 1428 741756

Date Buyer's Name Phone Email PO#
Customer Bill to Name and Address: Customer Ship to Name and Address:

Please supply a complete list of item in for service and include a description of issues with each tool. Also, if calibration is required, please indicate direction (CW/CCW) and duration of calibration (6 mo / 12 mo / etc.). RMAs for service not required. Please select "Warranty" column if warranty repair/service consideration is requested.

Qty Cal/Repair Tool Model # Serial # Describe Issue Warranty

* FOB: Shipping Point, Prepaid and Charge. Please provide your freight account number for freight collect shipments.
* Terms: Net 30 days with Approved Credit, [Credit Card, COD, Prepay]. In order to expedite your service request, please include a purchase order with your service form.
* Warranty: Please provide a copy of original PO for repair or service requested under warranty (must be supplied).
* Inspection fees may apply if repair quote is issued and declined or if repairs cannot be completed.

Mountz, Inc.
(Rev 6 - 12/02/2019)