RMA Request Form
Emerson Network Power will contact you with a Return Material Authorization (RMA) number or a request for additional information if needed.
Bold
fields are required information.
Company Name:
RMA request on behalf of:
(Company name)
Purchase Order Number:
Customer Ref#:
Customer RMA#:
Ship To
Name & Address:
Bill To
Name & Address:
(if same as Ship To Address, write "Same")
REQUESTOR CONTACT
Name:
Email:
Phone:
FAX:
TECHNICAL CONTACT
Name:
Email:
Phone:
FAX:
Root Cause Analysis:
Click here for RCA details
Comments:
Shipment of returned product should use proper electrostatic discharge precautions; pack the product in a suitable
container, including antistatic material and appropriate shipping container, preferably the original packaging.
Part#:
Serial#:
Problem Description:
Customer Part#:
Cust Rev#:
Customer Serial#: