BARCLAY ENTERPRISES, INC. www.barclayent.com

OPTIONAL REPAIR ORDER FORM

For your convenience, you may print and complete this repair order form and include it with your order. If you don't have a printer, then simply include a note on a plain sheet of paper with your name, address, telephone, email address and a description of the problems your phone equipment is exhibiting. It's also important for us to know if the problem is delayed and if it is intermittent. It's also a good idea to tell what you've already done to fix the problem, if anything.

COMPANY NAME _______________________________________________   YOUR PHONE #________________

YOUR NAME ___________________________________________________   YOUR EMAIL ___________________

YOUR ADDRESS ____________________________________________________________________________


WHAT ARE YOU SENDING US? ___________________________________________________________

WHAT ARE THE SYMPTOMS IT'S EXHIBITING? _________________________________________________________________________

IS THIS PROBLEM INTERMITTENT?  YES___   NO___ 

IS THIS PROBLEM DELAYED? (i.e., doesn't immediately appear when you first plug the unit in or try to use it) YES___   NO___


DO YOU WANT RUSH SERVICE? NO ___   YES* ____ (Specify 24 hour or 5 day): ___________________

* IF YOU WANT RUSH SERVICE, PLEASE READ ALL THE FOLLOWING!!!


NO PREPAYMENT REQUIRED! (In fact, please don't prepay ... it adds time to our bookkeeping!) AFTER WE'VE REPAIRED YOUR EQUIPMENT, we will call you for your credit card #.   Include this form with your order and mail/ship to:

BARCLAY ENTERPRISES, INC.   2275 LACROSSE AVE #201   COLTON, CA 92324

THANKS FOR CHOOSING BARCLAY ENTERPRISES, INC!   Setting the Standard  of Quality®