KUPA INC
AUTHORIZED REPAIR & SERVICE FORM

Thank you for your submission

Instructions: For your convenience you can print out the address label on page two and secure it to your package. Please keep a copy of all shipment tracking information you obtain. Include a copy of your receipt along with this completed form. You are responsible for shipping charges when sending your equipment in for repair. Kupa Incorporated is not responsible for lost or stolen items that are lost during shipping to Kupa Incorporated.

If you need additional help please call Customer Assistance: 1-800-994-5872 or 714-739-2081 or email Customer Service at: mail@kupainc.com