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Repair Return Form

Mailing Address:

ENMET Corporation

PO Box 979

Ann Arbor, Michigan 48106

Shipping Address:

ENMET Corporation

Attn: Repair Department

680 Fairfield Court

Ann Arbor, Michigan 48108

Phone Number: 734.761.1270

FAX Number: 734.761.3220

Your Mailing Address: Your Shipping Address:

Contact Name: __________________________ Your Phone: _______________________

Your PO/Reference Number: _______________ Your FAX: _______________________

Payment Terms: T COD

(check one)T VISA / MasterCard______________________ ________

Card number Expiration

Return Shipping Method:

T UPS: T Ground T 3 Day Select T Next Day Air T ND Air Saver T 2-Day Air

T Federal Express: T Ground T Express Saver T P-1 T Standard T 2-Day Air

T FedEx Account number: ________________________

Would you like ENMET to insure the return shipment?

T No T Yes Insurance Amount: $_________________

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