Electronics Support and Registration


Sony TV Optical Block Program Claim Form






Please use this claim to submit for reimbursement of out-of-pocket television optical block repair costs which resolved a stationary scribble / random line pattern on the screen.

You must provide BOTH a copy of your purchase receipt of qualifying TV model and optical block service receipt dated on or before May 26, 2006. Incomplete information or claims will not be processed. For check delivery by mail, please allow 8-10 weeks following Sony’s receipt of properly completed claim. Replacement of rear projection lamps or other parts are not covered by this program. All submissions must be postmarked no later than May 31, 2007. Offer limited to U.S. resident end users who paid out-of pocket fees for optical block estimates and/or repairs. Submitted materials become Sony property and will not be returned. Delivery to P.O. Boxes will not be accepted. Sony reserves the right to modify or cancel this program at any time and reserves the right to request additional information to validate a claim, making it subject to U.S. postal regulations. All other terms of the Sony limited warranty continue to apply. Offer available for following qualifying models KF-42WE610, KF-50WE610, KF-60WE610, KDF-70XBR950, KDF-60XBR950, KDF-42WE655, KDF-50WE655, KDF-55WF655, KDF-60WF655, KDF-55XS955, KDF-60XS955, KF-42WE620, and KF-50WE620.

Customer Information
Name:_______________________________________________________________________________
Address:______________________________________________________________________________
City: ________________________________ State: ______________ Zip Code: ____________________
Phone: _______________________________________________________________________________

TV Model Information
Sony TV Model Number: _________________________________________________________________
Sony Serial Number (located on the back of the TV): __________________________________________

Example:

Date of Purchase: _____________________ Retailer Where Purchased: ___________________________

Service Information
Name of Servicer: ______________________________________________________________________
Date of Service: ________________________________________________________________________
Cost of Repair/Service Evaluation (dollars):
Evaluation fee: $____________
Parts: $___________________
Labor: $___________________
Total: $________________
Description of Repair / Other Information:
______________________________________________________________________________________________________
______________________________________________________________________________________________________

 I do not wish to receive information from Sony about products, services, premium programs, contests and offerings that may be of interest to me.

You must include:
(1) Copy of Purchase Receipt (dated on or before 5/26/06)
(2) Copy of Service Receipt (dated on or before 5/26/06)
(3) This Completed Form

Mail this completed form to:
Sony Electronics Inc.
Attn: NSP TV Program
12451 Gateway Boulevard
Fort Myers, FL 33913

For questions, please call (877) 558-7669.


Copyright 2008, Sony Electronics Inc. All rights reserved.