Request for Return Material Authorization (RMA) Company Name* Email* Contact Person - First Name* Contact Person - Last Name* Phone Number* Phone Ext Purchase Order # Product 1 Description Serial # Part # Condition --Choose One--Factory SealedOpen Reason --Choose One--Dead on ArrivalFailed in ServiceDamagedMissing ComponentsWrong Product ShippedWrong Product Ordered RMA Type --Choose One--CreditReplacement Product 2 Description Serial # Part # Condition --Choose One--Factory SealedOpen Reason --Choose One--Dead on ArrivalFailed in ServiceDamagedMissing ComponentsWrong Product ShippedWrong Product Ordered RMA Type --Choose One--CreditReplacement Product 3 Description Serial # Part # Condition --Choose One--Factory SealedOpen Reason --Choose One--Dead on ArrivalFailed in ServiceDamagedMissing ComponentsWrong Product ShippedWrong Product Ordered RMA Type --Choose One--CreditReplacement Product 4 Description Serial # Part # Condition --Choose One--Factory SealedOpen Reason --Choose One--Dead on ArrivalFailed in ServiceDamagedMissing ComponentsWrong Product ShippedWrong Product Ordered RMA Type --Choose One--CreditReplacement Additional Information: Is this RMA Request due to a possible shipping issue? YesNo Is there evidence of internal or external package damage? YesNo If so, was carrier notified? YesNo Δ
