Service Request Form
Please fill out this form completly or print and fill out a
printable fax version
so that we can give you an RMA number to send in with your unit.
*
= Required Fields
C O N T A C T I N F O R M A T I O N
*
First Name
:>
*
Last:
CustID:
*
Organization
*
Phone:
Fax:
*
Email:
*
Shipping Address:
*
City:
State:
- -
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Other
*
Zip:
*
Country:
USA
Afghanistan
Andorra
Anguilla
Antigua
Antilles(Netherlands)
Argentina
Armenia
Aruba
Australia
Austria
Bahamas
Bahrain
Bangladesh
Barbados
Belgium
Belize
Bermuda
Boliva
Brazil
Cambodia
Canada
Cape Verde Islands
Cayman Islands
Chile
China
Colombia
Colombia
Cote d'Ivoire(Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Faeroe Islands
Fiji
Finland
France
Gabon
Gambia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Inmarsat
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kenya
Korea(North)
Korea(South)
Kuwait
Lebanon
Liberia
Liechtenstein
Luxembourg
Macao
Malawi
Malaysia
Malta
Mauritius
Mexico
Monaco
Montserrat
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Romania
Russian Federation
Samoa
Saudi Arabia
Singapore
Slovakia Republic
South Africa
Spain
Sri Lanka
Surinam
Sweden
Switzerland
Syria
Taiwan
Thailand
Turkey
United Arab Emirates
United Kingdom
United States
Uruguay
Venezuela
Virgin Islands
Yugoslavia
Zambia
Zimbabwe
Use same address for shipping and invoicing
Invoicing Address:
City:
State:
- -
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Other
Zip:
Country:
USA
Afghanistan
Andorra
Anguilla
Antigua
Antilles(Netherlands)
Argentina
Armenia
Aruba
Australia
Austria
Bahamas
Bahrain
Bangladesh
Barbados
Belgium
Belize
Bermuda
Boliva
Brazil
Cambodia
Canada
Cape Verde Islands
Cayman Islands
Chile
China
Colombia
Colombia
Cote d'Ivoire(Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Faeroe Islands
Fiji
Finland
France
Gabon
Gambia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Inmarsat
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kenya
Korea(North)
Korea(South)
Kuwait
Lebanon
Liberia
Liechtenstein
Luxembourg
Macao
Malawi
Malaysia
Malta
Mauritius
Mexico
Monaco
Montserrat
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Romania
Russian Federation
Samoa
Saudi Arabia
Singapore
Slovakia Republic
South Africa
Spain
Sri Lanka
Surinam
Sweden
Switzerland
Syria
Taiwan
Thailand
Turkey
United Arab Emirates
United Kingdom
United States
Uruguay
Venezuela
Virgin Islands
Yugoslavia
Zambia
Zimbabwe
P R O D U C T I N F O R M A T I O N
*
Unit Model:
Serial Number:
*
Problem:
Unit Model:
Serial Number:
Problem:
Unit Model:
Serial Number:
Problem:
Unit Model:
Serial Number:
Problem:
Amount Authorized for Repair:
Purchase Order #(if applicable):
Credit Card:
- -
Visa
MasterCard
Expiration:
Name as it appears on Card:
CMT will contact you within 24 hours to give you
pricing information
and a
RMA number
that you can attach to your units and then ship to us.
Caution:
Make sure you completly fill out the form before you proceed, or you might have to start over!
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