SERVICE REQUEST FORM

3 EASY STEPS. WHEN YOU CLICK FINISHED (AT BOTTOM) YOUR REPAIR SPOT IS RESERVED AND YOUR DETAILS ARE ENTERED INTO SEVERAL FORMS YOU MAY PRINT. WE ARE PLEASED TO OFFER 30 DAY CREDIT WHEN YOU SIGN AND DATE THE SERVICE REQUEST AND PROVIDE YOUR REGISTRATION (N NUMBER).

THE GREEN HIGHLIGHTED FIELDS ARE REQUIRED
THE YELLOW HIGHLIGHTED FIELDS ARE OPTIONAL
CLICK THE FINISHED BUTTON BELOW WHEN COMPLETE AND PRINT THE FORMS WITH YOUR PRINTER

PLEASE SIGN AND DATE THE SERVICE REQUEST FORM AND TAPE TO UNIT (FAA INSPECTION REQUIREMENT)

1. IF YOU KNOW YOUR TRANSPONDER NEEDS A REPAIR, AVOID OPTION 2 OR 3.
2. A $25 S/H FEE IS ADDED TO EACH ORDER, NOT PER UNIT. YOU MAY SHIP TWO OR MORE UNITS AND PAY ONLY ONE $25 S/H FEE.

1. SELECT SERVICE *AN ADDITIONAL $25 RETURN SHIPPING/HANDLING FEE WILL BE ADDED TO EACH ORDER*
CHOOSE SERVICE BY CLICKING IN LEFT COLUMN. GET MORE INFORMATION BY CLICKING ANY BLUE BUTTON ON RIGHT.
SELECT	SERVICE (FIRST 2 CHOICES INCLUDE 24 MONTH RE-CERT LOGBOOK STICKER)	COST	DETAILS
1.	TRANSPONDER REPAIR INCLUDES UP TO $25 PARTS, ALIGNMENT AND RE-CERT LOG ENTRY.	$99-259
2.	TRANSPONDER 24 MONTH RE-CERT WITH FULL ALIGNMENT.	$99
3.	TRANSPONDER BENCH TEST/EVALUATION.	$75
4.	TRANSPONDER & ENCODER BENCH TEST.	$105
5.	ENCODER BENCH TEST.	$45

SELECT	PAYMENT OPTIONS (SELECT ONE METHOD PER SHIPMENT)	DETAILS
1.	PREPAY. ENCLOSE CHECK OR MONEY ORDER IN BOX. $124 SUGGESTED
2.	30 DAY BILLING. TO CHECK YOUR ADDRESS ON FAA WEB SITE.

OPTIONAL INFORMATION

	I'M ALSO SENDING MY ENCODER (WITH TRANSPONDER)
	I'M SENDING ONLY MY ENCODER (NO TRANSPONDER)

SPECIAL RETURN SHIPPING INSTRUCTIONS
LEAVE THIS BOX BLANK IF YOU ARE USING OUR $25 FLAT RATE SHIPPING/HANDLING

PLEASE USE THIS BOX IF YOU WISH TO:

* USE YOUR OWN SHIPPER, ACCOUNT AND SHIPPING METHOD.
* USE OVERNIGHT OR OTHER EXPEDITED SHIPPING SERVICE.
* HAVE THE UNIT(s) DROP SHIPPED (PREPAID ORDERS ONLY).
* HAVE THE UNIT(s) RETURNED OUTSIDE THE CONTINENTAL USA.

NOTICE: ANY SPECIAL SHIPPING INSTRUCTIONS WILL CONVERT YOUR ORDER TO EXPEDITED STATUS.
CLICK HERE FOR DETAILS

3. CONTACT INFORMATION

REQUIRED FIELDS
NAME		COMPANY
ADDRESS		ADDRESS LINE 2
CITY		PURCHASE ORDER
STATE	ZIP CODE	COUNTRY
EMAIL
PHONE 1		PHONE 2

← CLICK HERE WHEN FINISHED

IF YOU DO NOT HAVE A PRINTER, OR YOUR PRINTER IS NOT WORKING.

	KING KT-76			ARC RT-359A
	KING KT-78			ARC RT-459A
	KING KT-76A			ARC RT-859A
	KING KT-78A			COLLINS TDR-950
	NARCO AT-150			COLLINS TDR-950L
	NARCO AT-50A			BENDIX TR-2061A
	NARCO AT-50 TSO			BENDIX TR-661A

	AIRCRAFT REGISTRATION NUMBER
	SERIAL NUMBER TRANSPONDER
	SERIAL NUMBER ENCODER