Repair Form

*ALL FIELDS ARE REQUIRED. PLEASE PRINT CLEARLY.

ORGANIZATION:________________________________________ PAYMENT INFORMATION
CONTACT:_____________________________________________ ___CREDIT
ADDRESS:____________________________________________ ___DEBIT
CITY:___________________STATE:_____ ZIP:_________
TELEPHONE:(_____) _______- ___________ CARD TYPE:_________________________
FAX (_____) _______ - __________ NUMBER:___________________________
E-MAIL:_______________________________________________ EXPIRATION:_________________________
DESCRIPTION OF PROBLEM: _____________________________ CW2(3 DIGIT CODE ON BACK):__________
______________________________________________________
______________________________________________________ PREAUTHORIZED AMOUNT:
______________________________________________________ ___$150
______________________________________________________ ___$250
DATE PURCHASED (IF KNOWN):___________________________ ___$500
PURCHASED FROM (CIRCLE ONE): ___$1000
(AMB) (DISTRIBUTOR) (CLUB) OTHER:______________________SIGNATURE__________________________
DATE_______________________________
LIST AMB EQUIPMENT SENT FOR REPAIR:

TRANSPONDER(S) DECODERS(S) SHIPPING METHOD PREFERRED

QTY QTY U.S.A

___ AMBrc DP ___ AMBrc __GROUND

___ AMBrc RECHARGEABLE ___AMB MX __NEXT DAY AIR
__2ND DAY AIR
___ AMB MX ___ACTIV
__ 3 DAY SELECT
___ AMB MX TRACKSIDE OEM ___ TRANX-2 SINGLE LOOP
___ TRANX160 ___ TRANX-2 EXTENDED LOOP
INTERNATIONAL
___ TRANX260 RECHARGEABLE ___ TRANX PRO __WOLRDWIDE STANDARD
___ TRANX260 DP ___ TRACK SIDE UNIT __WOLRDWIDE EXPRESS
___ TRANX Pro ___ TRANX3
___ AMB20 **PRODUCTS UNDER WARRANTY
___ ACTIV/ELITE DECODERS(S) SERIAL # RECEIVE FREE GROUND/
REQUIRED: STANDARD SHIPPING. ANY OTHER
___OTHER
SHIPPING METHOD CHECKED
NUMBER(S) REQUIRED: WILL BE CHARGED TO CREDIT
CARD. **

PLEASE ALLOW 1-2 WEEKS TO PROCESS REPAIR(S) FROM DATE OF ARRIVAL.

OFFICE USE ONLY:

DATE ARRIVED:__________ WARRANTY: Yes No
Website: www.amb-it.com
Repair Form
1. Repair Form: To insure an accurate repair of your equipment, AMB will thoroughly test your product
to diagnose the fault. Please complete the repair form above and retain a copy for your records. The
approximate testing and repair times for AMB equipment based on date of receipt is 2 weeks (excluding
shipping and administration time), depending on nature of the problem of the equipment.

2. Diagnosis: Each repair will incur a diagnosis fee of € 40,00 for each non-transponder product. If your
product requires an additional repair cost, this fee will be included in the repair costs. Diagnosis cost does
not include shipping or VAT.

3. Transponders: In some cases, your transponder may be replaced with a refurbished AMB transponder to
increase the speed of transponder repair. You may not receive the transponder(number) that was sent for
service.

4. Warranty Repairs: To insure you the fastest delivery of your equipment, all equipment repaired under
warranty incurring no cost will be shipped directly back to you.

5. Payment: AMB offers two forms of repair payment.

Standard: If your transponder requires payment, you will be notified of the cost before the repair is
completed. After receipt of payment, repair will be completed and shipped to you.
Expedited: If your transponder requires payment, you can pre-indicate a maximum cost of repair that
can be done. If your repair cost falls under the indicated amount, your provided credit card will
be charged and your repair will be completed. You will receive an invoice with the delivery of your
repair. To take advantage of this service, please complete credit card details below for one time
use:

6. Shipping and Delivery. Please securely pack your repair in a box (decoder) or padded envelope and
send to the address below. AMB is not responsible for loss or repairing damage that occurs during
shipment. AMB offers return transport by courier or airmail post. Courier is more costly than airmail post.
Only products under 500g can be shipped by post. Please note that damages or lost shipments per airmail
are the addressee’s responsibility.

Send repair(s) to:

3200 Highlands Parkway
Suite 104
Smyrna, GA 30082

Phone: 678.816.4000
Fax: 678.816.4001
E-mail: support@amb-us.com

Website: www.amb-it.com