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This form must be completed to obtain a Return Material Authorization (RMA) Number. Any products that may require return to our office for repair must have an RMA Number. Please enter a list of the serial numbers and the reason for the return in the table below.

Serial Number and Reason for Return

Product Type: AXS   M-AXS   Lite   Number to be returned: 

 Requested by: 
       Company 
       Address 
     Telephone 
           FAX 
E-mail Adderss

To Be Completed by Telcom Research:

Number of Non-Warranty Units: _______ Non-Warranty Repair Costs (US$): _______

RMA Number RMA Authorized by: ____________________

Non-Warranty Repair Cost Authorization

Repair Cost Authorized by: ___________________________ Date: ______________

Purchased from:_______________________________________________________

Copyright© 2011 Telcom Research
Last modified: October 16, 2011