BuckEye Cam

the leader in wireless and
standard camera systems

Service Return Form

Please fill out the following form and enclose it with the camera. This will help us expedite the requested service. Please send the camera to the following address:

Athens Technical Specialists Inc.
8157 US Hwy 50
Athens, OH 45701

* - required fields

Agency:

* Contact Person:

E-mail Address:

* Phone Number:

Fax Number:

* Billing address:	* Return shipping address:

* Camera Model # and Serial #:

* Service Requested:

* Method of Payment:

* Purchase Order / Credit Card #:

Expiration Date:

Name on the credit card:

Description of Problem or Special Instructions (if any):