| Name: | Phone: |
| Institution: | Fax: |
| Credit Card Number: | E-mail Address: |
| Name of cardholder: | Date Sent: |
| Expiration date: | |
| 3-digit security code from back of card: |
| Address for Equipment Return: | Address for Billing or Mailing of Paid Invoice: |
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| Address for all returns: AVM INSTRUMENT COMPANY, LTD. 10072 Streeter Road, Suite 5 Auburn, California 95602 USA |
Phone: 1-530-268-2369; Fax: 1-530-268-2387
e-mail: service@avminstrument.com
Website: www.avminstrument.com
Remember: When sending from outside the USA, mark package:
"USA-made Goods Returned to Manufacturer for Repair."