Module Rebuild Form
Fixer Corp.

Name___________________________________________________________________

Address________________________________________________________________

City__________________State-Province______________Zip Code_____________
	
Country______________



Phone Number___________________Email Address____________________________

VCR Make__________________VCR Model Number______________________________

Credit Card No._______________________Expiration_____Card Type__________

Signature________________________

Send to:

Fixer Corp.
381 S. Ames St.
Unit E-306
Lakewood, Colorado 80226

Phone (866)661-0274
International (303)934-1749

Print out this form on your computer, fill it in and send it in with your module. Module rebuild fee is $29.95. Return shipping is $5.00 for Priority mail with the Post Office. We are only set up to rebuild power supply modules that have a link to this page.

Most modules can be rebuilt in one to two days.

One year warranty!