Mobile Broadcast Equipment - Kokusai Denki America

Toll Free: (833) 227-1658

Email: [email protected]

Service Request Form

"*" indicates required fields

Contact Information

Company*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Name*

First Name Middle Initial Last Name

Job Title*

Email*

Company Phone*

Cell Phone*

Fax

Product

Model*

Serial No*

Dealer or Reseller*

Date of Purchase*

Purpose of Inquiry*

Check for In-warranty

Service Request

Symptom*

Please provide us the symptom[s] for which you would like your product diagnosed or repaired.

Problem*

Describe the problem experienced and your conclusion for the symptoms provided.

Operating Condition*

Inform us of the equipment's operating condition just prior and during the observation of the problem. Your accuracy will help us provide the most efficient and rapid service.

Loan Required*

Yes

Phone

This field is for validation purposes and should be left unchanged.

Warranty Registration Form

"*" indicates required fields

Contact Information

Company*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Name*

First Name Middle Initial Last Name

Job Title*

Email*

Company Phone*

Cell Phone*

Fax

Product Information

You can register up to 10 models. Click the Add Next Model button to add another model.

Model

Serial No

Dealer or Reseller

Date of Purchase

Dealer Invoice No

Comments

This field is for validation purposes and should be left unchanged.

Dealer Information

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