CUSTOM REPAIR FORM - Logitech

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CUSTOM REPAIR FORM
Customer Name for IEMs: _______________ Contact Name________________
Band/Group/Dealer (If Applicable):_________________________________

Monitor Issues:

Billing Information
Please provide us with the following contact information so that we can get in touch with you

Phone:________________________ Email:________________________________

Shipping Address*
Please state if this address is a residence or business.

Street
Address:_______________________________City:__________________________
State/Province:_________________________Zip Code: _____________________
Country:______________________
*NOTE: ALL REPAIRS ARE SHIPPED BACK AS COMPLIMENTARY UPS GROUND SHIPPING with

signature required
LET US KNOW IF YOU PREFER     

 2ND DAY AIR (+)  OR  

 NEXT DAY AIR (+)

Please Send Your Repair in with this document to the following address:
Ultimate Ears
Attn: Custom Repairs
3 Jenner ­ Suite 180  Irvine, CA 92618

UE Repair Form                               Version 1_6.27.13