Cooper Power Systems EAS Return Material Authorization Form

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Cannon Return Material Authorization Form

Please use this form to submit your request for return material authorization to Cooper Power Systems EAS.
Fields marked with a red asterisk * indicate required fields.

Are you looking for the Cooper Power Systems Product Warranty Service Request Form?

Requestor Information
*Requested By:
Requestor's Full Name:
Customer Information
*First Name:		*Last Name:
Title:		*Company Name:
*Address:		Address 2:
*City:		*State/Province:
*Postal Code:		*Country:
*Phone #:		Fax #:
*E-mail Address:		Date:
Product Information
Is the product located at an address other than the one provided above? If so please enter the contact name and location here:

Original Cooper Power Systems EAS Sales Order or Customer Purchase Order:
*Product Affected:	(Select the affected product from the drop-down list.) Select the type of affected product from this drop-down list.
Other Product (Not Listed):	If the product being submitted for RMA is not in the Product Affected list, enter the affected product in this text box.
*Part Affected:	(Select the part that most closely matches the affected part. To select multiple parts, hold down the Ctrl key) After selecting a product type from the Product Affected drop-down list, select the part that most closely matches the affected part from this list.
Other Part (Not Listed):	If a close match for the part that is being submitted for RMA can not be found in the Part Affected list, enter the affected part and style number in this text box.
*Quantity Affected:	Enter the total number of parts that are being submitted for RMA in this text box.
(Optional) Attach a file with serial numbers/ addresses and problems:	To attach a file, click the Browse button, navigate go to the directory where the file is located, and click Open. The submitted file must be less than 2 MB. To submit multiple files, combine them in a ZIP file.
*Serial number(s) of the CCU(s) associated with the CCU cards/parts submitted for RMA:	For the CCU cards/parts that are being submitted for RMA, enter the serial number(s) of the CCU(s) from which the cards/parts were removed.
*Serial number(s) of the Repeater(s) associated with the Repeater cards/parts submitted for RMA:	For the Repeater cards/parts that are being submitted for RMA, enter the serial number(s) of the Repeaters(s) from which the cards/parts were removed.
*Serial Numbers/ Addresses:	Enter as shown below: (1) Serial Number/Address 1 (2) Serial Number/Address 2 (3) Serial Number/Address 3 etc. (If serial numbers/addresses of the affected part(s) are included in an attachment, enter "See Attachment" above.)	*Description of problem(s):	Enter as shown below: (1) Problem for Serial Number/Address 1 (2) Problem for Serial Number/Address 2 (3) Problem for Serial Number/Address 3 etc. (If problems of the affected part(s) are included in an attachment, enter "See Attachment" above)
Date of Installation:	(enter as 03/01/2008)	Date of problem or discovery of issue:	(enter as 03/01/2008)
Is this the first notification of this request?	Yes No - Notification Date: (enter as 03/01/2008)

IMPORTANT Charges only apply to products that are NOT UNDER WARRANTY or to damage that is NOT covered by the warranty. If the product is NOT UNDER WARRANTY, by submitting this form, you agree to the following terms: If the product is Not repairable and you do not want it replaced, THERE WILL BE A MINIMUM REPAIR EVALUATION FEE CHARGED AND THE PRODUCT WILL NOT BE RETURNED TO YOU. If the product is repairable, there will be a repair price charged. If the product is Not repairable and you want it replaced, please provide a PO# . If you would like to be notified, please provide the name and number of someone to contact under special handling instructions. Special Instructions/Additional Notes:

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