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

Athens Technical Specialists Inc.
ATTN: BuckEye Cam Service
8157 US Highway 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 #:

* Method of Payment:

* Purchase Order / Credit Card #:

* Security Code:

Expiration Date:

Name on the credit card:

Description of Problem or Special Instructions (if any):