Repair Form
Today's Date: Ref #:
Customer Information
UR Acct#:
Contact Name:
Phone:  Ext:
Email:
Bill To:
Co. Name:
Address:
City:  State:  Zip:
Ship To:
 Same As Bill To  DropShip To:
      Co. Name:
      Address:
      City:  State:  Zip:
Warranty Information
Out of Warranty - You may wish to Pre-Approve this item up to $ 
Manufacturer's Parts & Labor Warranty - Include Bill of Sale
United Radio Guarantee
Unit Information
Symptom


Model#:
Password:
Serial#:

Do not send accessories unless related to the
problem with the equipment.
Accessories Sent:
Antenna

Case
Clip
Battery
Headset
Radio
Mic
Charger
Control Head
Other:
No/Low Power
Constant Tone
Secure
No Trunking
Blows Fuse
No Transmit
No/Low Audio
Cannot Read/Program
No Receive
Dead
No Squelch
No PL/DPL
Fail Code
Other/Specific Details:



Ship Product To:
Communications Division
5703 Enterprise Parkway
East Syracuse, NY 13057