SOUTHERN ELECTRONICS Inc. We fix what others can’t!
CLUSTER / SPEEDOMETER
REPAIR FORM ã SouthernElectronicsInc.com
Please print out, complete FULLY, and enclose with your
repair. Thank you for choosing Southern!
SALUTATION:_______ NAME__________________________________________
DATE ________/_______/________
RETURN ADDRESS FOR REPAIR TO BE SHIPPED TO: Location should be secure or
have someone to receive your unit.
·
Apartment or Suite____________Street Address
____________________________________________________________
·
City___________________________________________State
____________________ Zip Code__________ + _________
PHONE NUMBERS, Include Area Code. Daytime ______________
Evenings_________________ Pager / Mobile ________________
EMAIL ADDRESS PLEASE ENTER CAREFULLY AND LEGIBLY____________________________ @ _______________________
PAYMENT METHOD. PLEASE CHECK ONE:
™ CREDIT CARD, Please include the information below. No
charges made until ready to ship. For security, credit card Information
Is not kept in a computerized data base. You
may also call us toll free at 1-800-446-2880 with your card information.
·
CARD NUMBER ____________--
__________ -- __________ -- __________ EXP. Day _____ Month_____
Year_____
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CARD TYPE: ™ MasterCard ™ Visa ™ Discover ™ American Express
·
FULL NAME, As shown on card ______________________________
SIGNATURE_______________________________
·
ADDRESS WHERE CREDIT CARD STATEMENT IS RECEIVED IF DIFFERENT
FROM SHIP TO ADDRESS ABOVE:
·
Apartment or Suite __________ Street Address
________________________________________________________
·
City____________________________________ State
________________ZIP CODE_________________+_________
™ CHECK INCLUDED, Checks are cashed when received. Refunds for over payment will be sent
separately by US mail.
™ COD. Add $10.00 to estimates for the UPS COD fee. Sorry,
using UPS we cannot ship COD to a PO Box.
™ PRICE QUOTE REQUEST. ™ Please email quote to email address
above. ™ Please call with quote.
MAKE OF CAR ___________________
Model _________________________
Year _________________
ENGINE DISPLACEMENT IF KNOWN
__________ CYLINDERS _____ (Needed only for tach problems.)
MILEAGE______________ If mileage is unknown or needs to be reset, proof
of mileage is required. Recent service records
showing mileage with vehicle
identification (VIN) required and / or a sworn notarized statement. Odometer
tampering is a Federal crime!
WHAT IS THE PROBLEM WITH THE UNIT? Please check all boxes that apply and provide comments as
necessary.
The more information we
have the better we can troubleshoot the problem.
·
WHAT FUNCTION IS NOT WORKING? ™ Speedometer ™ Odometer ™ Tachometer ™ Backlight ™ Pointers
™ Gauges, which ones?
________________________________________________________________________________
™ Other , please explain
________________________________________________________________________________
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WHAT IS OCCURRING? ™ Cuts Off ™ Dead
™ Dim ™ Flickers ™ Erratic ™ Wiggles ™ Reads Incorrectly
™ Doesn’t Light ™ Other, please explain
_________________________________________________________________
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WHEN DOES THE PROBLEM OCCUR?
™ Always ™ Often ’ Rarely ™ When Hot ™ When Cold
™ On Bumps ™ Hitting Dash ™ Other, please explain ___________________________________________________
·
FOR SPEEDOMETERS OR ODOMETERS PROBLEMS, DOES VEHICLE HAVE CRUISE
CONTROL? ™ Yes ™ No
IF yes, does the cruise control cut out when your speedometer or
odometer has problems? This could be a bad Vehicle Speed
Sensor, or VSS, and not the cluster. Have it checked or call us for more
help toll free, at 1-800-446-2880.
Any More Details? ____________________________________________________________________________________