RMA (Return Merchandise Request) Form

RMA (Return Material Request) Form

Have you spoken with tech support? *

Person completing this form *

Dealer Name *

Account Number *

Contact Name *

Email *

Phone Number *

Shipping Address *

RMA Type *

Advance Replace
Credit

Enter one or more: Order Number, PO Number, Serial Number, Date of Sale *

Product Number *

Serial Number *

Model Number *

Quantity *

Time in Service *

Reason for Return *

#2 Product Number

Serial Number

Model Number

Quantity

Time in Service

Reason for Return

#3 Product Number

Serial Number

Model Number

Quantity

Time in Service

Reason for Return

Additional Notes

Prior to returning any products for exchange or credit, approval must be authorized by Zigen Corp and a "Return Material Authorization" number (RMA) assigned. The RMA number must appear on every shipping carton or the shipment may be returned at the customer's expense. All material returned to Zigen Corp. must match the authorized quantity and part numbers listed on the corresponding RMA form. The customer is responsible for any discrepancies in quantity or material. Additional materials not covered by the RMA will be returned to the customer or will be subject to a 25% restocking fee at the discretion of Zigen Corp. Materials claimed 'defective' that show no defect will result in return to the customer or an imposition of a 25% restocking fee at Zigen Corp option. No credit will be issued when materials returned under warranty display signs of misuse or abuse. Please ensure that returns are packed correctly in original packaging. No credit will be issued for materials returned in poor packaging which has resulted in shipping damage. Damaged materials and poor packaging will be returned to the customer at the customer's expense or scrapped at the customer's request. No credit will be issued for returned materials that have been used, modified or damaged by the customer. Materials returned for refund must be in new original condition. Receipt of original sale with date of purchase must be provided for all returns. All returns must qualify the product warranty time line for appropriate refund or credit. *

I agree to these conditions

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RMA (Return Material Request) Form

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