Shipping Form

Shipping Form

Please fill out this form, submit and print it; then attach it to your unit before shipping.
Company Name
First Name*
Last Name*
Cell Phone*
Email*
Today's date
Date Format: MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Model Number
Vehicle Make & Model
Vehicle Year
Serial Number
Description or Comment*
Ship to: Hi-Tech Electronic Services 7049 Valjean Ave. Van Nuys, California 91406
Tel:(818)785-8085 www.HiTechServ.com Email: service@hitechserv.com
PDF version of the submitted form will be available for download on the confirmation page.