Name Email Phone Number Equipment Model Number: Purchase Month/Year:

Antenna to Antenna Distance:

Obstructions In The Signal Path

None (Clear Line-of-site) Hills, Trees, Buildings or other

System Antennas

  Standard Omni Antennas   Long Distance Yagi Antennas

Are Antenna extension cables being used? If yes, list the distance: Are Antennas mounted at the same elevation? Enter Yes, or No, If No list the difference between them

Equipment Power

12V DC 24V DC 120V AC (Power Adapters)

Describe the Problem You Are Having In Detail Message Describe Any Troubleshooting You Have Done Message