Repair Voucher

Instructions: Please print this page out, fill in the appropriate areas and send it with the items to be repaired to:

Ensing, Inc.

Recognized for Quality & Integrity

7503 N. Florida Avenue
Citrus Springs, FL 34434
(352) 465-7777
(352) 465-7703 Fax

REPAIR VOUCHER

Company                                  Date:   /   /
Name:____________________________        Work Order #___________
Contact
Name:____________________________
Phone #   _______________________
Fax#        _____________________

Billing Address:                      Shipping Address:  (No P.O. Boxes)
_________________________________        _________________________________
_________________________________        _________________________________
_________________________________        _________________________________
_________________________________        _________________________________

                                                       (Telephones Only)
Qty:       Part#      Description of Problem    Refurbishing Requested Y/N

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Ensing, Inc
All Rights Reserved