Return Material Authorization Application Form

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Price Pump Company
RETURN MATERIAL AUTHORIZATION APPLICATION FORM
RMA #________________
An RMA NUMBER will only be issued after the following data is completed
and returned to Price Pump Company (FAX 707-938-0764)
Distributor”s Name:
RMA Returned by:
Address:
Phone:
Fax:
Your original P. O. Number or PPCO Invoice Number:
Please complete the following in its entirety. Make a copy for your records.
Pump BOM # (From pump label):
Description:
Motor information:
HP
RPM
Phase
Enclosure
Frame
Serial Number:
Fluid being pumped
Concentration
Note: A current material safety data sheet must accompany all pumps that are returned
(except for clean water applications).
Temperature:
F or
C Duty Cycle:
Continuous:
Intermittent:
Inlet Pressure:
Approximate hours in service:
Reason for return (Be specific):
Action to be taken (Check One):
Note: An inspection fee of up to $75.00 net will
____ Warranty evaluation?
be charged if product is not under warranty.
____ Estimate Repair Costs?
Restock Charge is 30%.
Note:
____ Restock products?
Person to contact with results _____________________________ Phone: _________________________
Upon receiving your RMA number please do the following:
1.
The pump must be clean and empty of all fluids or it will be returned freight collect.
2.
Contain pump so that no packing material can enter pump.
3.
RMA number must be visible on the outside container.
4.
Ship Prepaid Freight to "Attn: Returns Dept.". Collect shipments will be refused.
Price Pump Company: 21775 8th Street East, Sonoma, CA 95476 *
707-938-8441 * FAX: 707-938-0764
RMAWebForm, 11/15/2011, Rev. A

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