Survey/Mapping/Construction Service Request

To send your equipment in for repair, please complete our online form, or print and complete our paper form.

A completed form must accompany any equipment being shipped to CSDS for service. If you have any questions, please call: 800.500.1566.

Date Shipped

mm/dd/yyyy

Customer PO

Company *

Contact Person *

Full Name

Cell Phone Number *

Email Address *

Address *

Full Name

City

State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

Zip

Phone Number *

Fax Number *

Type of Equipment

Date of Purchase

mm/dd/yyyy

Extended Warranty Expiration Date: Hardware *

Extended Warranty Expiration Date: Software

Serial Numbers

Firmware Version

Action Request

Service Needed

Calibration, Check Out

Warranty Repair

Non-Warranty Repair

Other

Estimate Required?

Yes

No

Description of Problem

Error Codes Displayed on Instrument

Comments

Failure Information on Equipment

Is problem intermittent?

Yes

No

How often?

Temperature and weather conditions when failure occurred

Other

Was instrument dropped?

Yes

No

Did instrument get wet?

Yes

No

Sales Rep

Technician

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