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Midspan Products RMA Form

  In order for a RMA # to be issued, this form must be completed in full.

Contact Information
 
Company:
Sales Contact:
Sales Contact's Phone:
Sales Contact's E-Mail:
Technical Contact:
Technical Contact's Phone:
Technical Contact's E-Mail:
Return Shipping Address:
Billing Address:
 
Product Information
 
  Product #1 Product #2 Product #3 Product #4 Product #5
Part #
(mandatory)
Unit Serial #(s)
(mandatory)
Quantity
(mandatory)
PO Number
(Optional)
Warranty Status
(Optional)
Ship Date from PDSN (Optional)
 
Reason for RMA request
Unit does not work
Wrong parts received
Early shipment
Incorrect quantity
Stock Rotation
 
Failure Information

1. What is the point of failure?
Field failure
Incoming Inspection
Assembly
Qualification
Testing
Other (please specify)  

2. What is the source of your dissatisfaction?
Electrical (please specify)
Mechanical (please specify)
Other (please specify)

3. Please give a detailed failure description

4. What is the total quantity of failing parts?  

5. What is the quantity of parts that you will return for analysis?  

  • In case of physical damage (breakage), do not return the item. It cannot be fixed.
  • If item is under warranty and found non-defective, there will be a charge of $100.
  • If item is under warranty and found defective, there will be no charge.
  • If item is out of warranty and found non-defective, there will be a charge of $250.
  • If item is out of warranty and found defective, customer will be charged with 35% of your equipment Price List but no less than $250.



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