Work Performed Form
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1THIS FORM MUST ACCOMPANY YOUR RETURNED ITEM(S) - ADD RMA# ON BOX - ALL CUSTOMER INFORMATION MUST BE FILLED OUT
SHIP ITEMS TO: UNITED PARACHUTE TECHNOLOGIES - 1645 LEXINGTON AVENUE - DELAND, FLORIDA 32724-2106
CUSTOMER PROPERTY FORM
RMA Number: _________________
Received Date:
Warranty: Yes ☐ / No ☐
Sales Order:
Customer information
Work Performed
Name:
Initials
Description
Unit $
Total $
Address:
Telephone:
Contact:
Email:
Preferred time:
Container / Parts Information
Model
Serial number
DOM
Container
Main Canopy
Reserve Canopy
AAD
Parts included with container:
Main PC / Bridle:
Yes ☐ / No ☐
Main Bag:
Yes ☐ / No ☐
Main Risers:
Yes ☐ / No ☐
Main Toggles:
Yes ☐ / No ☐
Breakaway Handle:
Yes ☐ / No ☐
Reserve Handle:
Yes ☐ / No ☐
Reserve PC:
Yes ☐ / No ☐
Free Bag / Bridle: Yes ☐ / No ☐
RSL:
Yes ☐ / No ☐
Reserve Toggles: Yes ☐ / No ☐
Subtotal
Passenger Harness:
Yes ☐ / No ☐
Serial Number:
______________
Shipping
Other:
Total
Work requested:
Customer approval
Description:
Contact Date:
Email ☐ / Phone ☐ / In person ☐
Approval Date:
Email ☐ / Phone ☐ / In person ☐
Completed by
Final Inspection:
Employee:
Final Inspection:
Date:
After Pack:
Requested Person / Department:
Date shipped:
Invoice number:
FORM-005 REV. 6
NOTE: ITEMS NOT PAID FOR, OR COLLECTED, AFTER 6 MONTHS WILL SOLD BY UPT TO RECOUP REPAIR COSTS
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