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RMA Request
RMA Request Form
Date
*
Month
Day
Year
Company
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Shipping Address
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Billing Address
Name
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First
Last
Email
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Phone Number
Technical Contact Name
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Technical Contact Email
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Technical Contact Phone
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Quality Contact Name
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Quality Contact Email
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Quality Contact Phone
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Quality Assurance
Is RMA Request Submitted For Warranty Consideration? *
Yes
No
Report Number
Please e-mail any test/failure reports to Amherst_quality@lord.com referencing your RMA number or enclose any test/failure reports with the returned material upon receiving your RMA document.
Has A Non-Conformance Report Been Documented?
*
Yes
No
Scar Number
If a formal Corrective Action is required, please submit Supplier Corrective Action Request (SCAR) to Amherst_Quality@LORD.com and supply the SCAR Number.
Hazardous Material
Have The RMA Unit(s) Been Exposed To Hazardous Material?
*
Yes
No
RMA Unit(s) Must Be Cleaned Prior to Return. No Hazardous Material/Residues Shall be on the Returned Unit(s).
Note:
Customer must clean parts before returning, particularly if units have been exposed to hazardous material, to ensure evaluation of product can be performed in a safe manner. Product may be returned at your expense if deemed unsafe to handle.
Units To Return
Serial Numbers
*
Part Numbers
*
Return Reason
*
Calibration "as is" with calibration report
Calibration to manufacturer's specifications
Non-functional
Damaged
Return for credit
Out of specification - ambient (zero balance/span/static accuracy/shunt)
Out of specification (output temperature shift)
Other
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