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SR&D Rockman Database Entry Form
Owner's Name or Email:
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Select Model:
-- Choose Model --
A10-30
A12-50
A12-50r
Ace 50-12
Acoustic Guitar Pedal (Blue Button)
Acoustic Guitar Pedal (Gray Button)
Chorus Delay
Distortion Generator
Dual Remote Loop
Equalizer
Guitar Compressor
Midi Octopus
Midipedal
PA160
PA220
PA500
Pro Bass
PGE-2
Power Soak I
Power Soak II
Power Soak III
Rock Box
Rockman Tenth Anniversary
ROCKMAN Bass Ace
ROCKMAN Bass
ROCKMAN Guitar Ace
ROCKMAN Model I
ROCKMAN Model II
ROCKMAN Model IIb
ROCKMAN Metal Ace
ROCKMAN Octopus
ROCKMAN Rockbox
ROCKMAN Rockmax X100
ROCKMAN Soloist
ROCKMAN Ultralight
ROCKMAN X100
Rockmount RM-10
Stereo Chorus
Stereo Chorus Delay
Stereo Echo
Smart Gate
Super Head
Sustainor 100
Sustainor 100A
Sustainor 200
Sustainor 200 Rev9a
Sustainor 200 Rev19
Sustainor 200 Rev20
Sustainor X-12
Ultimatum Distortion Generator
Ultimatum Super Head
Ultimatum XPR
Ultimatum XP100
Ultimatum XP212
XP100
XP100a
XP212
XP212a
XPR
Other
Power Source:
-- Choose Power --
100V AC
117V AC
120V AC
220V AC
230V AC
12V AC
12V DC
18V DC
Other Voltage AC
Other Voltage DC
Manufacture Date:
Month
XXX
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
Day
Year
Date unreadable or missing
Serial Number:
This product does not have a serial number
Front Picture (optional):
Rear Picture (optional):
Other Picture (optional):
Refurbished Date (optional):
Refurbished By (optional):
-- Select Source --
RockmanRefurbs.com
RS&R of MA
Mike Donzelli
PSRR
Self
Other
Notes (optional):
I am not a robot
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