Customer Care Repair Authorization Form

Information in the pre-populated fields should automatically match your Customer Care Record. Email service@peinfo.com if any information on this form is incorrect, or if you have any questions or problems using this form.

NOTICE: This authorization form is linked to ONE Customer Care Record only. If you have multple active Customer Care Records, you will need to use the email link we provided for each individual record, and submit them individually.

Your Customer Care Number

Model Number

Serial Number

Total Service Charge**

** The total shown here (assuming repairs/services are elected) includes applicable diagnosis charges – unless you have already been invoiced for that separately. All charges shown are in USD. Freight charges are NOT included in this total. Refer to the repair quotation email for service charge details.

Authorization and Payment Confirmation

Provide your authorization for Repair, Return, or Dispose here:

New PO Number

This PO will replace the one we have on file and will be used for the total service charge. If you are a Pre-Pay customer, this field is optional but you can use this field to provide a PO for your own records.

Attach File (Optional)

Optional – use only if you already have a PO document file that you’d like to upload/include with this record. You will still need to fill out all of the applicable fields on this form if you provide a file.

Authorizing Contact Information

First Name

Last Name

Title/Position

Phone Number

Email Address

Shipping Logistics

Billing and Shipping Information

Billing Information

Billing Company Name

Billing Address

Billing City

Billing Zip Code

Shipping Information same as Billing Information

Shipping Information

Shipping Company Name

Shipping Address

Shipping City

Shipping State

Shipping Zip Code

Shipping Country

Is the destiniation a residential address?

Shipping Instructions (Optional)

About Power Electronics® International, Inc.®

As a world-class manufacturer of Micro-Speed® variable frequency drives and Smooth-Move® reduced torque control units, PE® equipment is world-renowned for high reliability and quality. Multi-Vector® drives also make PE® the world leader in heavy-duty closed-loop quality hoist speed control. With over a quarter of a million crane/hoist motions utilizing Power Electronics® International, Inc.® equipment, you can be assured if it's PE® then it's the best! PE® is also a UL and cUL approved manufacturer of quality control panels and automation systems.

Email: sales@peinfo.com
Phone: (847) 428-9494

All PE® products are MADE IN THE U.S.A.

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