Information from Precision Medical, Inc.

PM65/PM65HG Charge Recall Notice

Upon receipt of this information, Precision Medical will send you replacements for the chargers you listed below. Included with the replacement chargers will be a Return Goods Authorization. The Return Goods Authorization should be used as a packing slip when sending back the affected chargers. The recall policy requires Precision Medical to remove the affected chargers from the field as soon as possible. The receipt of all your defective chargers will complete your recall notice.

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	Easy Go Vac Serial Number		Charger Serial Number
1.		1.
2.		2.
3.		3.
4.		4.
5.		5.
6.		6.
7.		7.
8.		8.
9.		9.
10.		10.

I have read and fully understand the Customer Alert Product Recall letter regarding Precision Medical Easy Go Vac Aspirator charger part number 503974.

Information from Precision Medical, Inc.

PM65/PM65HG Charge Recall Notice

Company:

Name:

Address:

City:

State:

Postal Code/Zip:

Phone:

1.

1.

I have read and fully understand the Customer Alert Product Recall letter regarding Precision Medical Easy Go Vac Aspirator charger part number 503974.