RMA/RTV Request Form
CUSTOMER'S INFORMATION
Company Name
If applicable
Your answer
Full Name
First & Last Name
Your answer
Email Address
Your answer
Contact Phone Number
Your answer
Shipping Address
Street Address
Your answer
City
Your answer
State / Province
Your answer
Zip Code
Your answer
Country
Your answer
PRODUCT INFORMATION
Model Number (Product Name)
Please choose one from the drop box.
If "Accessory/Miscellaneous" is chosen, please enter the model name below.
Your answer
Model/ Product Serial Number
If the product does not have a serial number, please put "N/A"
Your answer
Problem Description
Please provide details of the issues you are experiencing with your product(s)
Your answer
Where did you purchased the product from?
Your answer
Purchase Date:
MM
/
DD
/
YYYY
Do you have more than one product to report?
If you answer "yes", it will redirect you to a blank Product Information page for you to report other products. Note that the first product you had entered on this page will already be recorded. You do not need to enter it again.
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