AutomotiveModules.com      Updated: February , 2019                                             (734) 228-8679
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                                                                                                                                                                                      we do not use email or text !
 MidwestTecKmart.com                    
                                                                   REFURBISHING ELECTRONIC CONTROLS                         
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                                                                                                Work Order 

Please print  or Copy & fill this order form and place it in the package with your Module that you send in.    
 FOR  ECUs, ECMs, TCMs Write  DTC CODES & its Description please. please do not alter this form.  

Name..................................................................Service Center Name..................................................................................

Address.................................................................................City..............................State.......................Zip........................


Phone #  (..........) ............  ................. Email or Cell Phone.  ........... ................... ............................. .................................................      

I am sending Module called..................................................................... Determined by qualified Tech: needs rebuild

The part Number is.....................................................................................................

Year...........Make..........................Model.......................Vin....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....  ....

Please write what is original customer Complain ?. Please write exact words of customer or driver of the car !
..............................................................................................................................................................................................

..............................................................................................................................................................................................

1-malfunction........................................................................................................................................................................

2-malfunction........................................................................................................................................................................

3-malfunction.......................................................................................................................................................................

4-malfunction......................................................................................................................................................................

Diagnostic Codes: #....................Code Full  description.....................................................................................................  

                                #......................Code  Full description...................................................................................................

                                #......................Code Full description....................................................................................................
please be advised for Certain Controllers such as some: ECUs, PCMs, 02 Escalade EBCM ,Corvette 98-2000 ABS Modules-with special  Feedback to EEPROM, Full Description of Fault Code off the scanner is critical for Turn around Time & The Fixed price that we declared.

Which Malfunction  Indicator Lights is on? ........................   ..........................  .......................

 I certify the malfunctions  and or  Codes described above areTrue and update and I Verified them, and I agree with the Warranty Term which in case if needed more repair in arrival or within warranty time I honor the term.   

Name...................... .................................. Signature.......................................................... Date...............................