Service & Repair Order Form
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Ship prepaid and insured to:
MAC Group, 75 Virginia Road, North White Plains, NY 10603
Phone: 914-347-3300 Fax: 800-321-2205
YES! I hereby pre-approve a repair estimate of $_______. If the charge is higher, contact me before proceeding.
Ship U.P.S. to the address below via:
Ground @ $20,
3rd day air @ $35,
2nd day air @ $40,
Next day air @ $50.
I hereby request expedited service at an extra charge of $30 (telephone in advance to make these arrangements).
City / State / Zip
Telephone / Fax
Method of Payment:
Name on Card
Signature / Date
Please include a letter with a thorough explanation of the problem or service to be performed. List each item, with serial numbers included in this shipment.
Service & Repair
All information and offers contained herewith apply to the USA only.
© 2012 Mamiya America Corporation