DEFECT AND ASSEMBLY FORM Box 760, 275 Hespler Ave, Winkler, Manitoba R6W 4A8 T: (800) 418-9461 P: (204) 325-4195 F: (204) 325-8116 www.meridianmfg.com Name (Dealer or Assembly Person)(Required) Business Name(Required) Phone(Required) Email(Required) Brand(Required)MeridianModel Number (eg. SLMD1072, TL1039)(Required) Serial Number(Required) Photo of DefectParts Missing (if any)Estimated/Actual Fix Summary(Required)CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
