SHIP TO: 
Att'n: Service Department
LUDECA, INC.
1425 NW 88th Avenue
Doral, FL 33172

Fax: (305) 468-1908

INCOMING REPAIR NOTICE
Required fields are noted with an asterisk (*). If info for a required field is not available,  please type in N/A.
We require that this form be sent to us prior to shipment. 
Please send this form by clicking on the 'Submit' button on the bottom on the form.
Date*    
Company* Plant*
Address* City*
State* Zip*
       
Contact1* Phone1*
Fax1*  E-mail1*
       
Contact2 Phone2
Fax2  E-mail2
       
PO No.    
Product* Serial No.*

Customer's Problem*:

Comments:

By*:    

This incoming repair notice will be kept on file for 30 days, after which time you need to submit a new one.

 

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