Customer Form

APT INSTRUMENTS

952-881-7095

The Exclusive Smiths Gauge World Wide Sales & Service Center

SERVICE INFORMATION FORM

(COMPLETE & INCLUDE WITH SHIPMENT)

Your Name ____________________________________________________________________________________________________________________

Complete Address (street, city, state):

________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________

Email _________________________________________________________Phone______________________________________________________

Year/Make/Model ________________________________________________________________________________________________________________

Volts (6 or 12) ___________________________________________________________________________________________________________________

Describe work you want done ________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________

Include any previous correspondence you have had with APT about this job. See S&H tips before packing and sealing. We recommend UPS or FedEx. Ship to:

(Cut and use for shipping label)
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APT Instruments Intl Inc
9632 Humboldt Ave S
Bloomington MN 55431

952-881-7095

We accept Visa, MasterCard, Discover, American Express, money orders, PayPal and checks.

Last modified: May 14, 2013