SRA Form for
CHRISTIE
Brand *
CHRISTIE
CHECKLIST
PLEASE DO NOT INCLUDE ACCESSORIES
(remote, power cord, mic, etc.)
PREFERRED CARRIERS
FEDEX or UPS
In Warranty?
In Warranty
Out of Warranty
Model *
--Select a Model--
* Other
4K10-HS
4K7-HS
Captiva DHD400S
Captiva DHD410S
Captiva DUW350S
Captiva410S
D12HD-H Black
D12HD-H WHITE
D12WU-H BLACK
D12WU-H White
D13HD2-HS
D13HD-HS Black
D13WU2-HS
D13WU-HS
D13WU-HS BLACK
D13WUS-HS
D16HD-HS
D16WU-HS
D20HD-HS
D20WU-HS
DHD1052-Q Black
DHD1075-GS
DHD400S BLACK
DHD400S White
DHD410S
DHD550-G
DHD555-GS Black
DHD555-GS White
DHD599-GS (Black)
DHD599-GS (White)
DHD600-G
DHD630-GS
DHD635-GS
DHD675-E
DHD700-GS BLACK
DHD700-GS White
DHD775-E
DHD800
DHD850-GS Black
DHD850-GS White
DHD851
DHD851-Q WHITE
DHD951-Q Black
DHD951-Q White
DS+10K-J
DWU1052-Q BLACK
DWU1075-GS
DWU550-G
DWU555-GS Black
DWU555-GS White
DWU599-GS (Black)
DWU599-GS White
DWU600-G
DWU630-GS
DWU635-GS
DWU675-E
DWU700-GS Black
DWU700-GS White
DWU775-E
DWU850-GS
DWU850-GS BLACK
DWU851-Q Black
DWU851-Q White
DWU951-Q
DWU951-Q Black
DWU951-Q White
DWX555-GS Black
DWX555-GS White
DWX600-G
DWX851-Q BLACK
DWX851-Q WHITE
DWX951-Q (White)
DWX951-Q BLACK
DXG1051-Q
LHD700
LHD720i-D
LHD878DS
LW401
LW41
LW502
LW551i white
LW555
LW651i
LW720
LW751I
LWU421
LWU501i
LWU502
LWU505
LWU530-APS
LWU601i
LWU620I
LWU630-GS
LWU650-APS
LWU701I
LWU701i White
LWU720i
LWU720i-D White
LWU720i-D Worldwide Black
LWU755-DS
LWU900-DS
LX501
LX502
LX505
LX601i
LX605
LX700
LX801I
Serial Number *
RMA Number
Purchase Date
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Select a State
Alberta
Alabama
Alaska
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
Newfoundland and Labrador
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Other
Zip *
Email Address *
Primary Phone *
Reason for Repair *
Save Original Box
(Note: If a box is deemed unsafe per carrier specifications, an additional fee will be charged with material costs to return your product)
Method of sending unit ?
DropOff
To Be Shipped
Method of return ?
PickUp
To Be Shipped
I have read the
Terms and Conditions