PACKING SLIP

  

Please fill out this form; print it; enclose it with your rig; and ship to:

  

Mike Nadeau

274 Covell Road

Fairfield ME 04937

Name:

Call Sign: 

Address 1:

Address 2:

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State:  Zip Code: 

Home Phone:

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Fax: 

Email:

 

Brand:

Model Number:

Serial Number:

Insurance Value: (for return shipment)  

  

Service Required:

 
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