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.