Name
Mailing Address
Area Code & Phone Number
Alternate Phone Number
Email Address
Credit Card Type
Credit Card #
Expiration Date
Receiver Brand
Model #
How many receivers are connected to the system?
Is the problem appearing on both receivers or only one receiver?
Does the problem happen on every channel or just certain channels?
(In the description, please list an example of the channels the problem appears on)
Does the problem only exist at certain times of the day, or is it there all the time?
Please write a detailed description of the problem you are experiencing:


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Carroll's Satellite Service
44221 North 20th St. West
Lancaster, CA 93435
661-943-2121 • rick@avsatellite.com