General Repair Form REV 3-2014

Centreville Electronics

9437 Main St.

Manassas, VA 20110

PH 888-645-0202   Fax 703-367-0868








Purchase Date and Dealer Information is NOT NEEDED for NON-WARRANTY REPAIRS





City_______________ State__________ Zip_____________


E-Mail (print in caps)_________________________________



Phone: ______________________________________


Problems with Unit








The minimum labor charge will be $70.00 plus parts and shipping.

The repair may be paid for using Visa, MasterCard, or PayPal. Or by sending us a check. .


Ship the Unit, Coil, Battery used with failed unit. We do not need the rods unless unit is a Factory hip mount.

Please print out the form, fill it out and send it with your unit. We will contact you within a week with the estimate.