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ToCF#1026
Issue. I am filing this Claim Form because my current address may be different from the
address contained in Norman’s Electronics, Inc.’s records.
❏ I paid either Toshiba or a third party service center (other than Norman’s Electronics, Inc.) to
upgrade the firmware on the Toshiba DVD Player At Issue specifically to resolve Playback
Incompatibilities experienced with the Toshiba DVD Player At Issue. I am attaching copies of
original, contemporaneously generated and dated documents (such as a bill, invoice or receipt)
showing:
a) that the firmware in the Toshiba DVD Player At Issue was upgraded by someone
(the attached documents must identify the name and address of the party who
performed the upgrade), AND
b) the amount I paid to upgrade the firmware in the Toshiba DVD Player At Issue.
YOU QUALIFY FOR THE REFUND FOR FIRMWARE UPGRADE COSTS REMEDY ONLY IF YOU
CHECK ALL OF THE FOLLOWING BOXES:
❏ I have completed Sections A, B, C and D above and provided both the Model Number and
Serial Number of my Toshiba DVD Player in Section B.
❏ I have chosen the refund for firmware upgrade costs remedy and have not selected any of the
other remedies listed on this Claim Form.
❏ I declare under penalty of perjury that the Toshiba DVD Player At Issue experienced one or
more Playback Incompatibilities on or before October 15, 2004.
SECTION F: FREE FIRMWARE UPGRADE OR REPLACEMENT REMEDY
YOU QUALIFY FOR THE FREE FIRMWARE UPGRADE OR REPLACEMENT REMEDY ONLY IF
YOU CHECK ALL OF THE FOLLOWING BOXES:
❏ I have completed Sections A, B, C and D above and provided both the Model Number and
Serial Number of my Toshiba DVD Player in Section B.
❏ I have chosen the free firmware upgrade or replacement remedy and have not selected any of
the other remedies listed on this Claim Form.
❏ I declare under penalty of perjury that the Toshiba DVD Player At Issue experienced one or
more Playback Incompatibilities on or before October 15, 2004.
Once your claim has been verified, you will be sent instructions for obtaining your free firmware
upgrade or replacement.
SECTION G: REBATE CERTIFICATE REMEDY
YOU QUALIFY FOR THE REBATE CERTIFICATE REMEDY ONLY IF YOU CHECK ALL OF THE
FOLLOWING BOXES AND COMPLETE SECTIONS 1-3, BELOW:
❏ I have completed Sections A, B, C and D above and provided both the Model Number and
Serial Number of my Toshiba DVD Player in Section B.