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RMA (Return Merchandise Authorization)

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Contact

Mandatory field Company*

Mandatory field Name*

Mandatory field Street*

Mandatory field Zip code*

Mandatory field City*

Mandatory field Country*

Phone

Mandatory field E-Mail*

Device

Mandatory field Product Name*

Mandatory field Serial Number*

Mandatory field Technical contact person (Phone, E-Mail)*

Detailed failure description

Mandatory field Message*

Divergent addresses?

Invoice address (if divergent)

Shipping address (if divergent)

Mandatory field Please respond to the following question:* What is the sum of 1 and 8?