Rma Request Form Page 5
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6RMA Request Form
For explanations and further instructions see RMA conditions.
Company details
Account number : _______________________________
Company name: _______________________________
Street: _______________________________________
Postalcode & City: ______________________________
Contact person : _______________________________
E-Mail: ______________________________________
Phone number: ________________________________
Customer reference number: _____________________
Collection details
Company name: ________________________________ Contact person: _______________________________
Street: ________________________________________ Postalcode & City: ______________________________
E-Mail: ________________________________________ Phone number: ______________________________
P/N
Quantity
S/N
Invoice number
1
___________________________________________________________________________________________
Detailed reason / Failure description:
____________________________________________________________________
2
____________________________________________________________________________________________
Detailed reason / Failure description:
____________________________________________________________________
3
____________________________________________________________________________________________
Detailed reason / Failure description:
____________________________________________________________________
4
____________________________________________________________________________________________
Detailed reason / Failure description:
____________________________________________________________________
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