Request Confirmed

Thank you submitting your request for repair. Please print this page and include it with your equipment you are sending in.

Ship To:
Data Capture Solutions
160 West Road (RT 83)
Ellington, CT 06029

Repair Type

Existing Customer:
Repair Type:
Under Warranty/Contract:
Account/Contract/Warranty Number :

PO Number:
Return Shipping Method :
Shipping Account Info:
Additional Comments :