Untitled Page

Request for Return Material Authorization (RMA) Questionnaire

Date
Contact Name
Address

City, State, Zip
Phone
Fax
E-mail

Orginal PO # to Enpac
Ship to Name
Address
City, State, Zip
Contact Name
Phone
Fax

End User Name
Address
City, State, Zip
Contact Name
Phone
Fax


Parts Number to Return / Quantity / Serial Number (If Applicable) List Each Part on separated by a space
Reason for Return (describe problem)

Have Photo's been sent to ENPAC?
Has the product been used?
If Yes, what chemicals & contaminates has the unit been in contact with? MSDS required for each.
Spill Documentation on the above spill?
Was the unit decontaminated?
Has the unit been cleaned of all debris/mud/misc so inspection of the unit can be made? *Clean up rate charged at $60.00/hour

As an authorized employee/agent for I hereby certify that the products to return has been decontaminated and poses no personal/environmental hazard while in transit or while being repaired/replaced/inspected by ENPAC LLC and its Suppliers and furthermore hold ENPAC LLC , its Suppliers, & Distributors harmless from any claims should they arise.
I agree with the disclaimer above. Date