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Repair Return Request
Please select RMA type :
Repair Return Request
Credit Return Request
Repair Return Request Form
Note
: Fields marked with an asterisk (
*
) are required. Serial numbers must be given before a Repair RMA number can be issued.
Basic Information
*
Contact Person :
*
Company :
*
Customer ID :
*
Date :
*
Telephone # :
Fax # :
*
E-Mail :
*
Technical Contact Person :
*
Telephone # :
Fax # :
*
E-MAIL :
Billing Address (If Out-Of-Warranty)
Company Name:
Address 1:
Address 2:
City:
State :
Country:
Zip Code:
Shipping Address
*
Company Name :
E-Mail:
*
Address 1 :
Address 2 :
*
City :
*
State :
*
Country :
*
Zip Code :
Repair Items
*
Part #
*
Serial #(See Note above)
*
Invoice #
*
Problem Description
New Item
Delete
Note 1
: Please provide BTOS serial number if entire system is being returned.
1.
*
Did the product work properly when you received it?
Yes
No
2.
*
Please indicate the Operating System:
3. Have any changes been made to the product, application, or operating system since it was last working?
*
Yes
No
If yes, please specify:
4. Is any third party hardware and/or software being utilized?
*
Yes
No
If yes, please specify:
Quotation before repair
Quotation before repair
Warranty Repair
Non-Warranty Repair
Cross Shipment Request ( Valid only within 30 days of original shipment and requires Advantech Management Approval )
For further details, contact: Tel: 1-888-576-9668 Fax: 408-519-3899
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