video game player repair information form
DESCRIPTION
Asurion Video Game Player Repair Information FormTRANSCRIPT
Video Game Player Repair Information Form(Please complete and return this form in the video game player shipping box and keep a copy for your records)Customer Information:Name ___________________________________Product Information:Brand _________________________________Service Request (SR#) not required____________ Serial #________________________________Return Address (Please No PO Boxes)____________________________ Model #________________________________City________________ State ____ Zip _______Email Address____________________________ Your email address is used to provide repair status updatesPhone __________________________________Please provide a brief description of the problem you are experiencing with your video game player/disc..____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PLEASE ENSURE THE FOLLOWING BEFORE SEALING YOUR PACKAGE:o Please DO NOT send cords, controllers, battery packs or other accessories. o PS3 customers do not need to remove the internal hard drive from their console.We only need your video game player to repair your unit. If you believe an accessory is defective or may be related to the cause of your problem and you are sending the accessory with your video game player, please take a moment to carefully indicate any additional items you are sending.Game ControllerVideo Game (name of game)________________________Power Cord Other __________________________________________AV Cables Hard Drive (size_____________)Memory Card***Important Disclaimer***Neither Service Provider nor Warranty Administrator shall be responsible for damage to, loss of, or disclosure of any data, game files, removable storage media or other content on products sent in for repair. You are responsible for backing up any data, game files, removable storage media or other content before sending your product for repair. Neither Service Provider nor Warranty Administrator shall be responsible for returning any accessories not listed above as well as any shipping damage incurred by not following the enclosed instructions. By signing below, you acknowledge that you have read and agree to this statement._________________________________________ _________________Signature Date_________________________________________Print Name Here