Please complete and return this form with your grinder for repair.

Send to: Baratza Repair

3923 - 120th Ave SE
Bellevue, WA 98006-1120

Baratza Grinder Repair Form

TODAY'S DATE:

____________________________

NAME:

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SHIPPING ADDRESS:

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CITY: _______________________ STATE: _________ ZIP: _________________

EMAIL ADDRESS:
PHONE NUMBER:
GRINDER MODEL:
GRIND PREFERENCE:

___________________________________________________________________
____________________________
____________________________ SERIAL NUMBER: ________________________

DRIP

ESPRESSO

TYPE OF BEANS USED: LIGHT ROAST

PRESS

MEDIUM ROAST

ASSORTED
DARK ROAST

BRIEF DESCRIPTION OF PROBLEM:

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_________________________________________________________________________
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NOTE: MOST GRINDERS CAN BE FIXED AND READY TO RETURN WITHIN 3 BUSINESS DAYS OF RECEIPT.

PLEASE SELECT YOUR METHOD OF PAYMENT:

BARATZA WEBSITE: Order your Grinder Repair here

Please include receipt and this form with repair.

(For streamlined service, please pre-pay online by Credit Card or PayPal.)

CHECK INCLUDED
For Washington add tax of 9.5%
For California add tax of 8.25%

IMPORTANT SHIPPING INSTRUCTIONS: Please pack the grinder in a sturdy box with adequate
cushioning material (not peanuts). Please DO NOT return the hopper, grounds bin, or timer
knob with the grinder.
I am NOT returning my grounds bin, hopper, or timer knob with my grinder.
OFFICE USE ONLY
RECD ___________________
PYMT _____________________
REPAIRED _____________________
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Rev 4/15