Applied Microphone Technology - microphones for trumpet, trombone, saxophone, clarinet, guitar, violin, harmonica, percussion, cello and more.

1) Contact information (PLEASE PRINT CLEARLY)

Name_________________________________

Street Address__________________________________

City_____________________ State______________Zip__________________

Phone_____ - _______ - ___________

2) Description of problem to be fixed:

3) Pieces being returned: (Check off all items your returning.)

· Microphone _______

· Clamp _______

· Wi5C transmitter _______

· ZR Receiver _______

· Power supply _______

· Hard Case _______

· Soft Pouch _______

· Cable _______

· BP45 Preamp _______

· Inline Preamp _______

· Studio Preamp _______

· BP40 Preamp _______

4) Credit Card Information: (Including will speed up return process) or call 973-222-1865 with info:

_________ ___________ ___________ ___________ EXP Date ___________

Billing Address:

____________________________________________

5) RA # (please contact tech support for your RA#) Ph: 973-222-1865

REPAIR RETURN FORM - Print and Fill out