EMIT - Calibration Repair Form

To view the calibration pricing on a unit click here.

Bill to Address:

Company Name:

Address:

City/Town:

State/Province:

Zip/Postal Code:

Country:

Ship to Address:

Company Name:

Address:

City/Town:

State/Province:

Zip/Postal Code:

Country:

Contact Info:

First and Last Name:

Phone Number:

E-Mail Address:

Return/Calibration/Repair for:

P.O. #:

Item/Model #:

Serial #:

Note: If there are multiple serial numbers, separate with slashes. Example: 507661612054/507661612055...

Type:

Price:

Shipping Method:

Shipping Account Number:

Reason for Return/Calibration:

Invoice/Sales Order # or Date when purchased:

Other Comments:

Payment Terms:

Net30

Cash in Advance

PAYMENT TERMS: Payment may be made by credit card or with net 30 terms if an account has been previously established with DII. Credit cards will be charged on invoice/shipment date. Credit card payments accepted by DII after date of invoice are subject to a 5% service charge.

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