Return Authorization

This form is for returning items only. Replacement items must be ordered separately.

Contact Information

Contact Name*

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Contact Email*

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Company Name

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Contact Phone*

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Original Order Information

Ship-To Company Name*

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Ship-To Address*

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Ship-To City*

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Ship-To State*

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Ship-To Zip*

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Ship-To Country*

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PO Number*

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Item Information:

Item Id*

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Item Description*

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Quantity*

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Unit of Measure *

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Item Serial Number (if applicable)

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If the item is a component of a piece of equipment…

Equipment description

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Equipment serial number

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Reason for Return*

Detailed Reason for Return*

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Was the item an original component of a piece of equipment?*

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Was the item used in any capacity after receiving?*

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Have you ordered a replacement?*

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If YES, purchase order number

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If YES, order date

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This form is for returning items only. Replacement items must be ordered separately.
Once this form is received it will processed and if the return is authorized you will be sent a RGA Number and instructions on how to return the item.
Do not return the item without first receiving a RGA Number authorizing the return.
Return of the item does not guarantee any credit or warranty replacement. Returned items will be evaluated.
Returned items may be subject to a “restocking fee”.
If damaged in shipping, keep all packaging material, until advised to discard.

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Return Authorization

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