R & R COMMUNICATIONS, INC.
302-475-1351

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Form To Be Completed And Sent With Equipment
Please Print

Name
Address
City
State
Zip Code
Phone Number (Home)	(        )
Cell Phone Number	(        )
"E" Mail Address
Date
*Warranty  (Circle One)	Yes       No

   *(You Must Furnish A Copy Of Your Dated R & R Sales Receipt For Warranty)
         (Warranty Is Only For Equipment Purchased At R & R)   (Warranty Is For The Original Owner Only)
         (We do Not Keep Copies Of Sales Receipts -It Is Your Responsibility)

Make
Model
Serial Number
Accessories Shipped With Radio

 Describe Below All Problems and/or Additional Work You Require. Please Print!!

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