WARRANTY REPAIR REQUEST FORM

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If you have any questions please contact customer service at 214-701-7133.

Send Repairs back to:

Repairs
WorkSite Lighting
10601 Cherry Hill Ave.
Baton Rouge, LA 70816

CUSTOMER INFORMATION

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First Last

Company/Location

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Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ITEMS FOR REPAIR(Required)

PART #

QUANTITY

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DESCRIPTION

REPAIR COMMENTS

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ADDITIONAL NOTES