ATACOM, INC. |
Return Merchandise Authorization Number Request Form |
To request a Return Merchandise Authorization (RMA) number, please review the RMA policies at http://www.atacom.com and complete this form and fax it to (510) 933-1201. ATACOM RMA Department will issue an RMA number based on the information contained in this form. Notification of the RMA number will then be faxed to the fax number or e-mail to the e-mail address you provided. |
Print All Field |
Customer Name*:___________________ | Company Name: _____________________ | ||
Phone Number*: ___________________ | Evening Phone Number:_______________ | ||
Fax Number: ______________________ | E-mail Address*:______________________ | ||
Address: ______________________________________________________________ | |||
Sales Order No.*: __________________ | Order Date :____/____/________ | ||
Item Description: |
Serial Number*: |
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Detail Problem Description: |
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Receive RMA Number: Fax E-mail |
Action Requested*: Replacement Refund |
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For ATACOM, INC. RMA Dept. Use Only |
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RMA Policy: |
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I have read and agree to the policies stated above |
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Print Name*:________________ |
Signature*: _________________________ |
Date*: ___/___/___ |
All * is required for RMA request to be processed. |