Return Merchandise Authorization (RMA) Form

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Contact (first and last name):*

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Company Name:

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Mailing Address:

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Suite/Apt.#:

City:

State:

Zip Code:

Country:

Telephone #:*

E-mail: *

Number of Items:

Model Number(s):

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Serial Number of the Equipment:

Invoice/Order Number:

Invoice/Order Date:

Select the type of equipment:*

Select ... DVR System (includes IP video servers) Camera Accessory Other, please specify in the notes below.

Type of RMA Request:

Select ... DOA In-warranty Repair Non-warranty Repair Refund Prepaid Cross-shipment

Reason for RMA Request:

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Description of the Problem (include any troubleshooting you have already attempted):*

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