If checked, attach copy of your Bill of Sale and provide No.
Inoperative Compressor / Unit
Equipment / Application
Name of Equipment Mfgr.
Manufacturers Unit Model No.
Date of Original Equipment Installation
Type of Refrigerant
How many compressors have failed on this equipment?
Cause of Failure (Check one or more)
Low Capacity (Describe symptoms)
Other (Please describe)
Why was service call initiated?
All returns MUST be tagged. Failure to tag or supply requested information WILL result in credit delay or denial.