RMA Request

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Company Name*

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Address*

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Contact Name*

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Contact Tel. No.*

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Contact Email Address*

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Please enter details of the items being returned. You can enter up to 5 different returns.

Part No.	Serial No.	Customer Purchase Reference	ETEL Reference	Quantity	Reason For Return
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I confirm that the items being returned are as supplied; clean and without modification. (Tick if this is true, untick if not true.)

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Please specify contamination and modifications. Include details of any oils, greases, adhesives, chemicals, material residues, or modifications to the items being returned.

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