SOUTHERN
ELECTRONICS Inc. We fix what
others cant!
CLUSTER
/ SPEEDOMETER REPAIR FORM
γ
SouthernElectronicsInc.com
Please
print out, complete FULLY, and enclose with your repair. Thank you
for choosing Southern!
SALUTATION:_______
NAME__________________________________________ DATE
________/_______/________
RETURN
ADDRESS FOR REPAIR TO BE SHIPPED TO:
Location should be secure or have someone to receive your
unit.
·
Apartment
or Suite____________Street Address
____________________________________________________________
·
City___________________________________________State
____________________ Zip Code__________ + _________
PHONE
NUMBERS,
Include Area Code. Daytime ______________ Evenings_________________ Pager /
Mobile ________________
EMAIL
ADDRESS PLEASE ENTER CAREFULLY AND LEGIBLY____________________________
@
_______________________
PAYMENT
METHOD. PLEASE CHECK ONE:
CREDIT CARD, Please include the
information below. No charges made until ready to ship. For security, credit
card Information
Is not kept in a computerized data
base. You may also call us toll free at 1-800-446-2880 with your card
information.
·
CARD
NUMBER ____________-- __________
-- __________ -- __________ EXP. Day _____ Month_____
Year_____
·
CARD
TYPE:
MasterCard
Visa
Discover
American Express
·
FULL
NAME, As shown on card ______________________________
SIGNATURE_______________________________
·
ADDRESS
WHERE CREDIT CARD STATEMENT IS RECEIVED IF DIFFERENT FROM SHIP TO ADDRESS
ABOVE:
·
Apartment
or Suite __________ Street Address
________________________________________________________
·
City____________________________________
State ________________ZIP
CODE_________________+_________
CHECK INCLUDED, Checks are cashed
when received. Refunds for over
payment will be sent separately by US mail.
COD. Add $10.00 to estimates for
the UPS COD fee. Sorry, using UPS we cannot ship COD to a PO
Box.
PRICE QUOTE REQUEST.
Please email quote to email address above.
Please call with quote.
MAKE
OF CAR ___________________ Model
_________________________
Year _________________
ENGINE
DISPLACEMENT IF KNOWN
__________
CYLINDERS
_____
(Needed only for tach problems.)
MILEAGE______________
If mileage is unknown or needs to be reset, proof of mileage is required. Recent
service records
showing mileage with vehicle identification (VIN) required
and / or a sworn notarized statement. Odometer tampering is a Federal
crime!
WHAT
IS THE PROBLEM WITH THE UNIT? Please check all boxes that apply and
provide comments as necessary.
The more information we have the better
we can troubleshoot the problem.
·
WHAT
FUNCTION IS NOT WORKING?
Speedometer
Odometer
Tachometer
Backlight
Pointers
Gauges, which ones?
________________________________________________________________________________
Other , please explain
________________________________________________________________________________
·
WHAT
IS OCCURRING?
Cuts Off
Dead
Dim
Flickers
Erratic
Wiggles
Reads Incorrectly
Doesnt Light
Other, please explain
_________________________________________________________________
·
WHEN
DOES THE PROBLEM OCCUR?
Always
Often
Rarely
When Hot
When Cold
On Bumps
Hitting Dash
Other, please explain
___________________________________________________
·
FOR
SPEEDOMETERS OR ODOMETERS PROBLEMS, DOES VEHICLE HAVE CRUISE CONTROL?
Yes
No
IF
yes, does the cruise control cut out when your speedometer or odometer has
problems? This could be a bad Vehicle Speed
Sensor, or
VSS, and not the cluster. Have it checked or call us for more help toll free, at
1-800-446-2880.
Any
More Details?
____________________________________________________________________________________
