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Service Release Form

I authorize BMA Industrial Inc. to repair my Biostar product unconditionally at my own risk. In addition, I would be responsible for any physical damage to my product during shipment to BMA Industrial Inc. Furthermore, I agree and am prepared to pay a flat $45 non-refundable service fee.
RED indicates required fields.
Full Name 
Product Model Number 
Product Serial Number 
Email Address 
Daytime Phone Number 
Purchase Place 
Purchase Date 
Mailing Address
(No PO Box or APO/FPO,
must be a UPS-deliverable
street address)
Detailed Problem Description 
Additional Comments 

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