Firearm Repair Form

Model Number:

Serial Number:

Are you the original owner?: YES NO

Name:

Date of Purchase:

Address (no PO Boxes):

City:

State:

Zip:

Phone (Daytime):

Fax:

E-mail Address:(if e-mail address is provided, notification of receipt and shipment will be sent)

E-mail Address:
I would like to receive future e-mail updates from Remington.

Please describe your problem and date of ocurrence:

characters left

Ammunition Information:

Manufacturer:

Type:

Other (i.e. bullet weight/type, shot size, powder):

Handload Information:

Powder Used:

Powder Weight:

Case/Hull Used:

Primer Used:

Bullet Type/Shot Size:

Reloader Used:

Firearms Care (Cleaning and Lubrication):

Brand of cleaning solution used:

How often do you clean the bore? (Months or Number of rounds)

How often do you clean the action? (Months or Number of rounds)

How often do you clean the trigger assembly? (Months or Number of rounds)

Brand of lubricant used:

How often do you lubricate the bore? (Months or Number of rounds)

How often do you lubricate the action? (Months or Number of rounds)

How often do you lubricate the trigger assembly? (Months or Number of rounds)

Have you reviewed the cleaning and maintenance recommendations on our web site or in our owners manual? YES NO

When was the last time that your firearm was serviced by a Remington authorized repairman/gunsmith?)

What were the services performed?)

NOTE: In order to better service our customers some firearms/parts are sent to a certified Remington Premier Authorized Repair Center.

Ship your ENSURED firearm by either UPS or Parcel Post to:

Please select a state from above to view the address of the Premier Field Service Center in your area.

WARNING: DO NOT SEND LIVE OR SPENT SHELLS IN YOUR FIREARM OR IN THE SAME BOX WITH THE FIREARM. THIS IS A VIOLATION OF FEDERAL LAW. IF YOU FEEL YOU MUST SEND SPENT SHELLS PLEASE SEND THEM IN A SEPARATE PACKAGE AND INCLUDE NAME, ADDRESS (WITH ZIP CODE), TELEPHONE AND MODEL AND SERIAL NUMBER OF YOUR FIREARM.

:: Record the serial number of your firearm before sending it.
:: Pack your firearm for safety and to prevent further damage in shipping and handling. Preferably,
   ship in a firearm box. (Note: Original boxes may not be returned.)
:: Remove all accessories from your firearm to prevent loss or damage.
:: Provide a return address on both the outside and inside the box. Shipments without a proper
   return address will be refused.
:: Ship your ENSURED firearm by either UPS or Parcel Post. Remington is not responsible for
   damage or loss during shipment, so you may elect to purchase insurance from your carrier.


Firearm Repair Form NOTE: Please complete and print this form, and then include it with your firearm.	Return to Previous Page