ERA REPAIR TAG – TWO COPY Size 8, 6-1/4” x 3-1/8”, Cut Corners 9/16” Patch, 3/16” Hole Two-Part w/Carbon Sequentially numbered TOP COPY Perforated Tear Line Sequential Numbers OOOO1 owe. PO #: PHONE: CONTACT: UNIT TYPE: VOLTAGE: 6 12 24 32 GROUND:NEG POS MAKE: MODEL: UNIT PROBLEM: YEAR: REBUILD OR EXCHANGE ESTIMATE [_] CORE ONLY DATE INSTALLED WARRANTY/ DATE FAILED NEED BY: ERA MEMBER COMPANY NAME 123456 W. ANYWHERE DRIVE, CHICKASAW, OK 77777 E-Mail: someemailaddress@myrebuildingbusinesss.com www. myrebuildingbusinesss.com 414-259-1166 www.electricalrebuilders.org FORM T1 BOTTOM COPY Sequential Numbers OOOO1 owe. PO #: PHONE: CONTACT: UNIT TYPE: VOLTAGE: 6 12 24 32 GROUND:NEG POS MAKE: MODEL: UNIT PROBLEM: YEAR: REBUILD OR EXCHANGE ESTIMATE CORE ONLY DATE INSTALLED WARRANTY! DATE FAILED NEED BY: ERA MEMBER COMPANY NAME 123456 W. ANYWHERE DRIVE, CHICKASAW, OK 77777 E-Mail: someemailaddress@myrebuildingbusinesss.com www. myrebuildingbusinesss.com 414-259-1166 CLAIM CHECK O O O O 1 weve Perforated Claim Check Sequential Numbers ERA REPAIR TAG – SINGLE COPY Size 8, 6-1/4” x 3-1/8”, Cut Corners 9/16” Patch, 3/16” Hole Sequentially numbered Sequential Numbers OOOO pws: PO #: PHONE: CONTACT: UNIT TYPE: VOLTAGE: 6 12 24 32 GROUND:NEG POS MAKE: MODEL: UNIT PROBLEM: YEAR: REBUILD OR EXCHANGE ESTIMATE [ ] CORE ONLY DATE INSTALLED DG DATE FAILED NEED BY: ERA MEMBER COMPANY NAME 123456 W. ANYWHERE DRIVE, CHICKASAW, OK 77777 E-Mail: someemailaddress@myrebuildingbusinesss.com www.myrebuildingbusinesss.com cramcHeck QQQO1 e282 Perforated Claim Check Sequential Numbers