Specifications

PARADIGM
PARTS REQUEST FAX FORM
Please fax this form to (1-626-810-2166)
OR YOU CAN EMAIL CUSTOMER SERVICE REQUESTS TO
[e-mail]
NAME: ________________________________________________________________
ADDRESS: _____________________________________________________________
CITY ______________ STATE ______________ ZIP __________________
TELEPHONE: (Day) ______________________________________________________
(Night) _____________________________________________________
(Email Address) _____________________________________________
SERIAL#: __________________________________________________
MODEL#: __________________________________________________
PURCHASE DATE: ______________________________________________________
PURCHASE FROM: ______________________________________________________
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
PART # DESCRIPTION QTY
OFFICIAL USE ONLY
SHIP DATE: ___________________________________________
TRK #: _______________________________________________
BACK ORDER: ________________________________________
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