return merchandise authorization form

Return merchandise authorization form

If you believe a device is malfunctionning or is out of service, please fill out the form below with as much information as you can. Once the form has been submitted, a technician will contact you to try and resolve the issue. If it cannot be resolved, the form will be authorized.

Number ID

Name

(if dealer) Contact

Phone number

Fax

Invoice number (if dealer)

Name of dealer (if customer)

Return Shipping Address

Name

Street Adress

City, Postal Code

Country

Special shipping instructions

Product information

Warranty Non-warranty Unknown

Product Type

Date of purchase

Serial Number

Reason / Issue