mag upright pc - Paradigm Health &

Electric Treadmill with Pulse
1020H.5-020317
OWNER’S MANUAL
PLEASE DO NOT RETURN THIS PRODUCT TO THE STORE.
STOP. Contact customer service if you have any questions
regarding assembly or proper operation of the machine.
Email us at:
Service@paradigmhw.com
Or call us at:
1-844-641-7921
Hours:
8:00 am to 5:00 pm (PST) Daily
TABLE OF CONTENT
SERVICE ---------------------------------------------------------------------- 2
LABEL PLACEMENT ------------------------------------------------------- 3
IMPORTANT SAFETY GUIDELINES ----------------------------------
4
OVERVIEW DRAWING ---------------------------------------------------- 8
PARTS LIST ------------------------------------------------------------------
9
HARDWARE & TOOL LIST-----------------------------------------------
11
ASSEMBLY -------------------------------------------------------------------
12
COMPUTER ------------------------------------------------------------------ 15
STORAGE --------------------------------------------------------------------
19
ADJUSTMENTS ------------------------------------------------------------
20
MAINTENANCE ------------------------------------------------------------
23
TROUBLE SHOOTING ---------------------------------------------------
25
WARRANTY ------------------------------------------------------------------
26
PARTS REQUEST FORM ------------------------------------------------
27
1
SERVICE
IMPORTANT: FOR NORTH AMERICA ONLY
For damaged or defective product, questions, replacement parts or any other service
support, please contact our customer service department by the below methods:
For The Best Service, please Email:
service@paradigmhw.com
Response Time: 1-2 Business Days
Emailing us with the information above will be the best method to receive a response
during peak business hours
Website:
www.paradigmhw.com
Toll-Free:
1-844-641-7921
(8:00 AM - 5:00 PM Pacific Standard Time, Daily)
Response time may vary via calling
Please have the following information ready when requesting for service:
•
Your name
•
Phone number
•
Model number
•
Serial number
•
Part number
•
Proof of Purchase
For damaged or defective product please contact our customer service before returning
to the store.
Paradigm Health & Wellness, Inc.
1189 Jellick Ave.
City of Industry, CA 91748, USA
2
LABEL PLACEMENT
3
IMPORTANT SAFETY GUIDELINES
Basic precautions should always be followed, including the following safety
instructions when using this treadmill: Read all instructions before using this treadmill.
DANGER: To reduce the risk of electric shock, please read the following:

Always unplug the treadmill from the electrical outlet immediately after using
and before cleaning, assembling, or servicing.
NOTE: Failure to follow these instructions may lead to personal injury and
cause damage to the treadmill.
WARNING: To reduce the risk of burns, fire, electric shock or injury to any persons,
please read the following:
 Never leave the treadmill unattended when plugged in. Disconnect by turning
off the master power switch, and unplugging from outlet when not in use and
before putting on or taking off parts.
 Use this appliance only for its intended use as described in this manual. Do
not use attachments not recommended by the manufacturer.
 Never operate this treadmill if it has a damaged cord or plug, or if it is not
working properly. If it has been dropped or damaged, or been exposed to
water, return the appliance to a service center for examination and repair.
 Do not attempt any maintenance or adjustments other than those described in
this manual. Should any problems arise, discontinue use and consult Customer Service.
 Never operate the appliance with the air openings blocked. Keep the air
openings free of lint, hair, and the like.
 Do not use the treadmill outdoors.
 Do not pull the treadmill by its power cord or use the cord as a handle.
 Keep children and pets away from the equipment while in use. This machine
is designed for adults only. This appliance is not intended for use by persons
with reduced physical, sensory or mental capabilities, or lack of experience and
knowledge, unless they have been given supervision or instruction concerning
use of the appliance by a person responsible for their safety. Keep children
under the age of 13 away from this machine.
 Do not operate where aerosol (spray) products are being used or where
oxygen is being administered.
4
IMPORTANT SAFETY GUIDELINES






Keep Dry - do not operate in a wet or moist condition. Save these
instructions.
Do not operate the treadmill near a blanket. Excessive heating can occur and
cause fire, electrical shock, or injury to user.
Keep electrical cord away from heated surfaces.
Never insert any object into any opening.
Keep the treadmill on a solid, level surface with the minimum safety area
clearance of 2000mm x 1000mm of the treadmill. Be sure the area around
the treadmill remains clear during use and has adequate clearance.
This treadmill is for household use only.
 Only one person should be on the treadmill while in use.
 Wear comfortable and suitable clothing when using the treadmill. Do not use
the treadmill barefoot, in only socks or in sandals, always wear athletic shoes. Never wear loose
clothing because it could run the risk of getting caught in the treadmill.
 Always hold on to the handrails while using the treadmill.
 Always make sure the storage latch is in place when folding and moving the
treadmill.
 Do not leave children who are under 13 years old unsupervised near or on the
treadmill.
 To disconnect, turn all controls to the off position, then remove plug from outlet.
 This appliance is not intended for use by persons (including children) with
reduced physical, sensory or mental capabilities, or lack of experience and
knowledge, unless they have been given supervision or instruction concerning
use of the appliance by a person responsible for their safety. Children should
be supervised to ensure that they do not play with the appliance.
 Pull up the Safety Tether Key for emergency stop. Reinstall the Safety Tether
Key onto the Computer Console. Press the START/STOP button to begin
exercise again.
 Maximum Weight Capacity is 400 lbs / 182kgs
 This treadmill is designed for WALKING only.
 CAUTION: Risk of Injury to Persons –To Avoid Injury, use extreme caution when stepping onto
or off of a moving belt. Read Instruction Manual Before Using.
Note: It is the obligation of the owner to review and explain these safety precautions to all
users of this treadmill.
5
IMPORTANT SAFETY GUIDELINES
GROUNDING INSTRUCTIONS

This product must be grounded. If it should malfunction or break down,
grounding provides a path of least resistance for electric current reducing the
risk of electric shock. * This treadmill is equipped with a cord having
equipment grounding conductor and a grounding plug. The plug must
be plugged into an appropriate outlet that is properly installed and
grounded in accordance with all local codes and ordinances.
DANGER: Improper connection of the treadmill grounding conductor can result in the risk of
electric shock. Check with a qualified electrician, if you are in doubt as to whether the product is
properly grounded. Do not modify the plug provided with the treadmill. If it will not fit your outlet,
have a properly grounded outlet installed by a qualified electrician.
This product is for use on a nominal 120 volt circuit and has a grounding plug that looks like
the plug illustrated in sketch A in Figure 1.
Make sure that the product is connected to an outlet having the same configuration as the
plug. No adapter should be used with this product.




This unit must be plugged into a nominal 120 volt outlet which has been grounded.
Keep hands clear of all moving parts. Never place hands or feet under the Treadmill while in it
use.
Do not use the treadmill on a carpet that is greater than 1/2 inch in height.
Before using the treadmill, check that the belt is aligned and centered on the walking deck and
all visible fasteners on the treadmill are sufficiently tightened and secure.
6
IMPORTANT SAFETY GUIDELINES
WARNING: Before beginning any exercise program consult your physician. This is
especially important for the persons who are over 35 years old or who have pre-existing health
problems. Read all instructions before using any fitness equipment. We assume no responsibility
for personal injury or property damage sustained by or through the use of this product. Do not
operate this exercise equipment without properly fitted guards, as the moving parts can present
risk of serious injury to young children.
CAUTION: Read all instructions carefully before operating this product. Retain this
Owner’s Manual for future reference.
7
OVERVIEW DRAWING
8
PARTS LIST
Part #
Description
Qty
Part #
Description
Qty
1
Main Frame
1
26
Computer MT18
1
2
Handlebar
1
27
Safety Tether Key
1
3
Incline Adjuster
1
28
Triangle Knob M6X45mm
2
4
Safety Tube A 480*30*40mm
1
29
Handlebar Knob
2
5
Safety Tube B
T1.2*20*20*350mm
1
30
Cross recess Phillips Screw
M10X50mm
2
6
Air Piston
1
31
Cap Nut M10
2
7
Hex Bolt M12X90mm
2
32
Lock Nut M10
2
8
Stabilizer Knob
4
33
Foam Grip φ32*T2.0*2480mm
2
9
Adjustable Pad
5
34
Handlebar End Cap
φ50*37.5mm
2
10
Transport Wheel
φ51*φ8.5*20mm
2
35
Speed Quick Key
1
11
Bushing φ12*φ8.4*15mm
4
36
Self-Tapping Screw
ST4*16mm
4
12
Hex Socket Bolt
2
37
Power Cord
1
13
Lock Nut M8
2
38
Socket
1
14
Square End Cap 30*30*12mm
1
39
Power Switch
1
15
Hex Socket Bolt
1
40
Fuse Box 10A
1
16
Flat Washer M8
1
41
Wire for Switch
1
17
Bushing 30*30*28mm
1
42
Wire for Power Control Board
1
18
Bushing 26*26*50mm
1
43
Power Control Board
1
19
Hex Socket Bolt M8X35mm
1
44
Power Control Plastic Plate
1
20
Lock Nut M8
2
45
Self-Tapping Screw 3X12 mm
4
21
Square End Cap 20*20*12mm
1
46
Phillips Screw M5X12mm
4
22
Hex Socket Bolt M8X20mm
1
47
Lock Nut M5
4
23
Hex Socket Bolt M8X30mm
1
48
Inductor
1
24
Wire Plug φ16
2
49
Cross Head Screw M5X8MM
2
25
Signal Cable 2200mm
1
50
Spring Washer φ5
3
M8X65mm
M8X44mm
9
1800mm
PARTS LIST
Part #
Description
Qty
Part #
Description
Qty
51
Motor
1
70
Rear Roller
1
52
Optical Coupler
1
71
Motor Cover
1
53
Hex Bolt M8X25mm
4
72
Phillips Screw M5X10mm
10
54
Spring M8
4
73
Side Rail
2
55
Flange Nut M8
4
74
Self-Tapping Screw
ST5*14mm
8
56
Rubber Pad 55*35*8.5mm
6
75
Rear Left End Cap
1
57
Support Board 50*12*T4*556mm
1
76
Rear Right End Cap
1
58
Round End Cap φ25*15mm
2
77
Spring Knob 54*27*27mm
1
59
Incline Adjuster End Cap
φ45*40mm
2
78
Short Knob 43*23*23mm
1
60
Phillips Screw M10X40mm
2
79
Flat Washer φ10*T1.5mm
2
61
Bushing φ14*φ10.2*19mm
2
80
Stabilizer 374*820*1081mm
1
62
Deck 945*560*T20mm
1
81
Left Stabilizer Tube
1
63
Phillips Screw M6X35mm
8
82
Right Stabilizer Tube
1
64
Flange Nut M6
8
83
End Cap 50*25*17.5mm
2
65
Front Roller
1
84
Function Quick Key
1
66
Hex Socket Bolt M8X55mm
3
85
Cross recessed Pan Head
Screw M3x8mm
2
67
Phillips Screw M6X25 mm
1
86
Cross Head Screw M5X10
MM
3
68
Belt 180/J6
1
87
Flat Washer φ5
3
69
Walking Belt
2140*515*T1.6MM
1
10
HARDWARE & TOOLS PACK
(8) Stabilizer Knob 4 PCS
(28) Triangle Knob
6mm Allen Wrench
1 PC
2 PCS
Silicone Oil
1 bottle
11
ASSEMBLY
Step 1
1a. Lowering the Treadmill: Ensure that the treadmill is standing upright. Place one hand firmly on
the walking platform and pull the Spring Knob (77) out to allow the Main Frame (1) to lower itself.
Be careful to not be under the treadmill as it is lowering. Ensure that the Spring Knob (77) “POPS”
into the locked position and that the Main Frame (1) is flat with the ground.
WARNING: Have a firm hold on the treadmill as it is being lowered. Do not stand under the
treadmill as it is lowering. Be sure that the Spring Knob is locked in place.
12
ASSEMBLY
Right
Left
Step 2
2a. Installing the Right & Left Stabilizer Tubes: Install the Right Stabilizer Tube (82) into the
Stabilizer (80). Align the holes on both parts and insert two Stabilizer Knobs (8) through the holes.
Thoroughly tighten the Stabilizer Knobs (8) by turning in a clockwise manner.
Repeat this step to install the Left Stabilizer Tube (81) to the Stabilizer (80).
Hardware:
(8) Stabilizer Knob
4 PCS
13
ASSEMBLY
(28) Triangle Knob 2 PCS
Step 3
3a. Handlebar Placement: Pull out the Short Knob (78) and then lift the Handlebar (2) until it is
perpendicular to the Stabilizer (80) frame. Ensure that the Short Knob (78) "POPS" into the
locked position after the Handlebar (2) is adjusted. Secure the Handlebar (2) to the Stabilizer (80)
with two Handlebar Knobs (29) and two Flat Washers (79).
Step 4
4a. Connecting the Wires: Connect the larger Signal Cable (25) from the Handlebar (2) to the
similar Cable coming from the Computer (26). Connect the Black Function Quick Key (84) and
the White Speed Quick Key (35) from the Handlebar (2) to the similar Black and White Wires
coming from the Computer (26).
4b. Installing the Computer: Attach the Computer (26) onto the Handlebar (2) with two Triangle
Knobs (28). Be sure to tuck the excess wires into the frame. Place the Safety Tether Key (27)
onto the Computer (26).
14
COMPUTER
Quick Start:
Plug the Power Cord (37) into a wall outlet and flip the Power Switch (39) that is located at the
front of the treadmill to the ON position. Make sure the Safety Tether key (27) is positioned on the
Computer (26) then attach the Safety Clip (other end of the Safety Tether Key) securely to your
clothing. Always begin the treadmill standing on the side rails, not on the belt. The treadmill will start
moving at a speed of 0.4 MPH. While in the Quick Start mode, use the UP and DOWN buttons to
adjust the speed.
Button Functions:
START/STOP: Press the START/STOP button to start or stop the treadmill.
MODE: Press the MODE button to select each function (TIME, DISTANCE, or CALORIES) for set
up a workout goal value.
SET: Use the SET button to confirm goal values of TIME, DISTANCE, or CALORIES.
RESET: Press the RESET button to clear data values of TIME, DISTANCE, or CALORIES to zero.
Press and hold the RESET button for 2 seconds, and the console will be restarted.
SPEED UP: Press the SPEED UP button to increase speed.
SPEED DOWN: Press the SPEED DOWN button to decrease speed.
15
COMPUTER
Computer Functions:
TIME: Displays your elapsed workout time in minutes and seconds.
SPEED: Displays the current speed from the minimum 0.4 MPH to the maximum 4.0 MPH. You
may increase or decrease the speed by pressing the UP or DOWN button on the computer
console.
DISTANCE: Displays the cumulative distance traveled during your workout.
CALORIES: Displays the total cumulative calories burned during your workout.
PULSE: The PULSE window will display your current heart rate 4 - 5 seconds after you grip the
hand pulse sensors with both your hands. To ensure the pulse readout is precise, always grip the
hand pulse sensors with two hands instead of just with one hand when you try to test your heart
rate figures.
NOTE: If the equipment is left inactive for 5 minutes, the computer display will show a clock (time)
and room temperature; that is called sleep mode. In sleep mode, all previous pre-set data and
training data are kept and will show up when any button is pressed.
16
COMPUTER
Pre-Set:
PRE-SET TARGET GOALS: The computer allows for 3 different Pre-set target features,
Time/Distance/Calories. To set a Target, have the computer in stop mode and press the MODE
button to select one of the 3 targets. The display will flash, ready for you to press SPEED UP or
SPEED DOWN to adjust the goals. Press the SET button to confirm the Time/Distance/Calorie
target. Once you have made your selection, press the START button to begin.
PRE-SET TARGET TIME: A pre-set target time range can be set from 1:00 to 99:00 minutes. The
walking belt will start moving with an initial speed of 1.0 MPH. The speed can be adjusted using the
SET button. Time will count down from the set value to 0:00, The Computer will BEEP when the
Target is met.
PRE-SET TARGET DISTANCE: A pre-set target distance range can be set from 0.10 to 99.0 miles.
The walking belt will start moving with an initial speed of 1.0 MPH. The speed can be adjusted
using the SET button. Distance will count down from the set value to 0.00, The Computer will BEEP
when the Target is met.
PRE-SET TARGET CALORIES: A pre-set target calorie burn range can be set from 10 to 9,990
calories. The walking belt will start moving with an initial speed of 1.0 MPH. The speed can be
adjusted using the SET button. Calories will count down from the set value to 0. The Computer will
BEEP when the Target is met.
17
COMPUTER
MODE: Press MODE button on the Left Handrail to select each function (TIME, DISTANCE, or
CALORIES) for set up a workout goal value.
On/Off: Press the On/Off button Located on the Left Handrail to start or stop the treadmill.
SPEED UP: Press the SPEED UP button on the Right Handrail to increase speed.
SPEED DOWN: Press the SPEED DOWN button on the Right Handrail to decrease speed
18
STORAGE
A
B
Handlebar Knob (29)
Spring Knob (77)
C
D
Handlebar (2)
Short Knob (78)
FOLDING THE TREADMILL
For your convenience, the treadmill can be folded up and placed in a storage area.
To fold the treadmill, pull out the Spring Knob (77) while slowly lifting up the Main Frame (1) up
and allowing the Spring Knob (77) to POP in place. See Figure A.
Loosen both of the Handlebar Knobs (29). See Figure B.
Pull out the Short Knob (78) and then push the Handlebar (2) all the way down. Insert both
Handlebar Knobs (29) back to the Stabilizer (80) as shown in Figure C. If you have folded the
treadmill correctly, then it should look like Figure D.
IMPORTANT: TO PREVENT INJURY PLEASE MAKE SURE YOU HAVE A FIRM HOLD ON THE
MAIN FRAME WHEN LIFTING UP OR SETTING DOWN THE DECK.
19
ADJUSTMENTS
Adjustable Pads:
There are five Adjustable Pads (9). There is one on the bottom of both Left and Right Stabilizer
Tubes (81) & (82). There are three on the bottom of the Stabilizer (80). Turn the various
Adjustable Pads (9) as needed to level the treadmill.
20
ADJUSTMENTS
Belt Adjustment:
The belt may come loose during transportation and/or from use. After prolonged use of the treadmill,
the belt will stretch out. If the belt is shifting to the left, turn on the main power switch of treadmill
and let the belt run at the speed of 1-1.5 MPH. Using the Allen Wrench provided, turn the left rear
roller adjustment bolt 1/4 turn in the clockwise direction. You should see the belt start to correct
itself by moving back toward the center. Repeat the above procedure until the belt is properly
centered.
If the belt is shifting to the right, turn on the main power switch of treadmill and let the belt run at the
speed of 1-1.5 MPH. Using the Allen Wrench provided, turn the right rear roller adjustment bolt 1/4
turn in the clockwise direction. You should see the belt start to correct itself by moving back toward
the center. Repeat the above procedure until the belt is properly centered.
If the belt is slipping during use, turn off and unplug the treadmill. Using the Allen Wrench provided,
turn both left and right rear roller adjustment bolts 1/4 turn in the clockwise direction for the same
amount, then turn on the main power switch of treadmill and let the belt run at the speed of 1-1.5
MPH. You should now walk on to the belt to determine if the belt is still slipping. Repeat the above
procedure until the belt no longer slips.
21
ADJUSTMENTS
Incline Adjustment:
Place one hand on the rear end of main frame. Lift the main frame up then adjust the Incline
Adjuster (3) to the desired position.
Two Incline Degree Options:
3 % Incline degree when Incline Adjuster at Position A.
6 % Incline degree when Incline Adjuster at Position B.
22
MAINTENANCE
Silicone Oil
The treadmill been coated with "Silicone Oil" in advance. Silicone oil is a non-volatile oil and by the
time you receive the treadmill, there should be oil permeated through the belt. There will be no
need to re-apply the oil under normal circumstances. To maintain the belt, "Silicone Oil" may be
re-applied once the resistance has been increased and the belt starts rubbing against the walking
deck. To re-apply the Silicone Oil to the treadmill, lift up the belt, one side at a time, and apply the oil
directly to the center of the walking deck. Allow the silicone oil to 'set' for one minute before using
the treadmill.
Attention: Only use "Silicone Oil" lubricants for this equipment. In addition, do not add any other
type of oil; otherwise the treadmill will be damaged. Do not over-lubricate the walking board.
Excess lubricant should be wiped off with a clean towel.
23
MAINTENANCE
WARNING: To prevent electrical shock, please turn off and unplug the treadmill before cleaning or
performing routine maintenance.
CLEANING
The treadmill can be cleaned with a soft cloth and mild detergent. Do not use abrasives or solvents.
Be careful not get excessive moisture on the display panel as this might cause an electrical hazard
or electronics to fail. Keep the treadmill, especially, the console, out of direct sunlight to prevent
screen damage.
STORAGE
Store the treadmill in a clean and dry environment. Ensure the master power switch is off and is in
the off position and the power plug is un-plugged from the electrical wall outlet.
24
TROUBLESHOOTING
Error Codes Cause and Solutions
Fault Code
Cause
Solution
1. Ensure that the Safety Tether Key is installed on the
Computer (57).
SAFE
2.Restart the power after 1 minute and install the Safety
Safety tether key protection Tether Key
3. Computer IC Board damaged, Contact Customer
Service.
1.Restart the power, and retry after 1 minute
Er1
Computer receiving error
signal up to 15 seconds.
2.Ensure the sensor cable is connected perfectly
3.Signal cable or computer IC board damaged,
Discontinue use and contact Customer Service
1. Restart the power and retry after 1 minute. Check if
the input voltage is lower. Use when voltage is normal
Er3
Low Voltage
2.Signal Cable or power IC board damaged, Discontinue
use and contact Customer Service
1. Restart the power, and retry after 1 minute
1.Motor Cable become loose
Er5
2.Check the motor cable , make sure it is connect
perfectly
2.Motor is blocked
3.Check the motor quality, make sure there is no visible
damage.
3.Motor damaged
4.Ensure the running belt is thoroughly lubricated.
5.Motor or power IC board damaged, Discontinue use
and contact Customer Service
1. Restart the power, and retry after 1 minute
Er7
Power IC board not receiving 2.Ensure that the sensor cable is connected perfectly
signal
3. Signal cable or power IC board damaged, Discontinue
use and contact Customer Service
25
WARRANTY
MANUFACTURER’S LIMITED WARRANTY
Paradigm Health & Wellness warrants to the original purchaser that this product is free from
defects in material and workmanship when used for the purpose intended, under the
conditions that it has been installed and operated in accordance with Paradigm’s Owner’s
Manual. Paradigm’s obligation under this warranty applies to the following:
COMPONENT
LENGTH OF WARRANTY
Structural Frame
1 year
Motor
5 years
All Other Components
90 days
(computer display, electronics, upholstery, foam, ball bearings, pulleys, belts, cables, wires,
shocks, covers, tension, internal mechanism, wheels, pedals, knobs, accessories and
hardware)
Exclusions from Warranty Coverage:
Paradigm does not warrant against and is not responsible for, and no implied warranty shall be deemed to cover, any
product failure, product malfunction, or damages attributable to:
1. Improper installation and/or failure to abide by Paradigm’s installation guidelines;
2. Use of this product beyond normal home use, or in an application for which it was not designed;
3. Cosmetic items such as scratches, dents or discolorations;
4. Damage caused by normal wear and tear, vandalism, accidental or by animals;
5. Any act of Nature (such as fire, flooding, snow, ice, hurricane, earthquake, lightning or other natural disaster),
environmental condition (such as air pollution, mold, mildew, etc.), or staining from foreign substances (such as dirt,
grease, oil, etc.);
6. Normal weathering due to exposure to sunlight, weather and atmosphere which can cause colored surfaces to,
among other things, flake, chalk, accumulate dirt or stains.
7. Improper operation, alteration, handling, storage, abuse or neglect of the products.
Paradigm, using its sole discretion, will either repair or replace free of charge any part(s) proven to
be defective under normal home use. Any repair or replacement shall provide no new warranty
coverage, but shall retain only the remaining portion of the original product’s warranty. This
warranty is offered only to the original purchaser and is not transferable. Proof of original purchase
is required.
Ordering Replacement Parts
Replacement parts can be ordered by emailing our customer service department:
Service@paradigmhw.com
Open Daily 8:00 AM - 5:00 PM (PST).
When ordering replacement parts please have the following information ready:
1. Owner’s Manual
2. Model Number
3. Description of Parts
4. Part Number
5. Date of Purchase
26
PARTS REQUEST FORM
Paradigm Health & Wellness, Inc.
EMAIL THIS FORM WITH YOUR RECEIPT OF PURCHASE TO
Service@paradigmhw.com *
NAME:_____________________________________________________________________________________
ADDRESS:__________________________________________________________________________________
CITY:________________________ STATE:_____________ ZIP:_______________________________________
TELEPHONE: (Day)__________________________________________________________________________
(Night)_________________________________________________________________________
SERIAL#:___________________________________________________________________________________
MODEL#:___________________________________________________________________________________
PURCHASE DATE:___________________________________________________________________________
PLACE OF PURCHASE:_______________________________________________________________________
PART #
DESCRIPTION
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
* This form can also be faxed in Fax #: 626-810-2166
27
QTY