LinksWell Inc

Return Request Form

Dealer Name:

Contact Name:

Contact Phone:

Contact Email:

Street Address:

City

State:

Zip Code/Postal Code:

Model Number:

Date of Purchase:

Serial Number:

System Equipped w/iGO

Requesting a (select one):

Repair

Exchange (Defective unit must be received at factory warehouse before replacement is sent)

Advanced Exchange (Replacement unit sent prior to receiving defective unit. Must be approved by selling dealer - CREDIT CARD DEPOSIT REQUIRED)

Credit

Reason for Return:

Attachment:

Allowed file types: .jpg,.pdf,.png,.bmp