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Repair RMA Form

SYSCON-PlantStar RMA Request Form

All RMA requests must be done via the internet.  Please complete the form below and our Customer Service department will contact you within 24 hours.

Print This Form

Repair Date*: (mm/dd/yyyy)

RMA Number:

CONTACT INFORMATION:

Name*:

Company*:

SHIPPING ADDRESS:

Street Address*:

Address 2:

City*:

State*:

Zip Code*:

BILLING ADDRESS: if different than above.

Street Address:

Address 2:

City:

State:

Zip Code:

PHONE, FAX, & EMAIL:

Phone Number*:

Fax Number:

Email *:

UNIT / REPAIR INFORMATION:    

Unit Serial Number*                      
Unit Model Number*:                       
Software Type*:                                 
Version Number:    
                        
Advance Exchange
*:                         Yes  No
Cables Included?*:                             Yes   No  - If Yes, Quantity:  
Auxiliary Cards Included?*:             Yes  No  - If Yes, Quantity:   
Description of Card #1:                  
Description of Card #2:                  
Description of Card #3:                  

Problem (include PO, please)*:


 

1108 South High Street - South Bend, IN 46601 - Phone: 574-232-3900 - Fax: 574-287-5916

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