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Request for RMA (Return Material Authorization)

The information requested below is essential to processing your request. Please read the Return and Repair Policy before submitting an RMA request; you may also read and download the policy in PDF format (32K PDF).

Required fields are highlighted and marked by an asterisk.

If you prefer, you may print this page, then fax the completed form to the appropriate country:

Germany: +49 (0)89 60822-150
UK: +32 (0)16 35 21 01
Other: +32 (0)16 35 21 01

By completing and sending this form by fax, you confirm that you have read and accept the Elo TouchSystems Privacy Policy.

 
Contact*
Company*
Phone*
Fax
E-mail*

Original Purchasing Information

Invoice to Name*
Invoice to Address1*
Invoice to Address2
Invoice to Address3
Invoice to City*
Invoice to State/Province
Invoice to Postal Code*
Invoice to Country*

Ship to Information

Ship to Address1*
Ship to Address2
Ship to Address3
Ship to City*
Ship to State/Province
Ship to Postal Code*
Ship to Country*

Additional Comments

Returned Product 1:

Quantity*
Elo Part #*
Elo Invoice #
Serial #*
Problem Description*

Returned Product 2:

Quantity*
Elo Part #*
Elo Invoice #
Serial #*
Problem Description*

Returned Product 3:

Quantity*
Elo Part #*
Elo Invoice #
Serial #*
Problem Description*

Returned Product 4:

Quantity*
Elo Part #*
Elo Invoice #
Serial #*
Problem Description*

Returned Product 5:

Quantity*
Elo Part #*  
Elo Invoice #
Serial #*
Problem Description*

I have read and I accept the Elo TouchSystems Privacy Policy:

I have read and I accept the Return and Repair Policy.

Name*
Title

March 2006