*Company  .

*Telephone...

*Serial Number  .

*Problem...

  (Please Select from List) Radio Does Not Transmit Radio Does Not Receive Radio is Dead (Battery Okay) Radio Audio Volume is Too Low Radio Audio has Static/Background Noise Radio Receives Non-Regal Users Radio has Intermittent Problem (Describe Below) Radio has Physical Damage (Describe Below) Radio has Problem Not Listed (Describe Below) Analyze/Recondition Battery (Quantity Below)