Return Authorization

Company Name *

First Name *

Last Name *

E-mail *

Phone Number *

Original Purchase Order Number *

Is a replacement needed? *

Part Number *

Serial Number (if applicable)

Condition of item(s) - please be as specific as possible. Example: in original packaging, new without box, used, etc. *

Reason for Return *

Check this option for out of box failure and please fill out a detailed description of the failure symptoms.

Out of box failure description

I agree to the Terms of Use and acknowledge that I have read the Privacy Notice*

Online Form for Return Authorization