PLEASE NOTE THIS IS NOT A CREDIT REQUEST OR EXCHANGE FORM. THIS FORM IS FOR WARRANTY SERVICE ONLY. PLEASE CONTACT YOUR POINT OF SALE FOR RETURN FOR CREDIT OR EXCHANGE INSTRUCTIONS. 

 1. Please Completely fill out this form (include Model# and Serial #)

 2. Failure to provide this information will result in a denied warranty claim.

 Fax number (562)483-8498 Attn: RMA Department

Note: Proof of Purchase document must be provided in the form of an itemized receipt or invoice that lists an Elite Screens brand item and Date of Purchase.

* Fields are mandatory

Company Name First Name*   Please enter your first name Last Name*   Please enter your last name Phone (Home)*   Field not valid (required or bad value) Phone (Work)   Field not valid (required or bad value) Phone (Cell)   Field not valid (required or bad value) Fax   Field not valid (required or bad value) E-Mail*   Field not valid (required or bad value) Location Street*   Field not valid (required or bad value) City*   Field not valid (required or bad value) State/Province*   Field not valid (required or bad value) Postal Code*   Field not valid (required or bad value) Country   Field not valid (required or bad value) Purchase Information Date of Purchase*   Field not valid (required or bad value) Point of Purchase Name*   Field not valid (required or bad value) Phone of Dealer   Field not valid (required or bad value) Invoice #*   Field not valid (required or bad value) Model #* (Located on sticker at screen case end cap or packaging box)   Field not valid (required or bad value) Serial #* (Located on sticker at screen case end cap or packaging box)   Incorrect serial number Version #* 2.0  1.4-1  1.4  1.3  1.2  Other  (Located on the back of remote control,etc. V1.4)   Field not valid (required or bad value) Problems Problem* Choose one...  No Power  Missing Parts  Screen Material  Product Function Problem  Shipping Damage  Others (please explain below)    Field not valid (required or bad value) Description of the Problem / Question*   Field not valid (required or bad value) Proof Documents (Form will not submit if proof of purchase is not attached) Proof of Purchase (Max 500kb)*   Field not valid (required or bad value) Defect / Damage Screen Picture 1 (Max 500kb) Defect / Damage Screen Picture 2 (Max 500kb) REMEMBER TO ATTACH YOUR PROOF OF PURCHASE OR FORM WILL NOT SUBMIT     Field not valid (required or bad value)