JCM American Corporation - Return Materials Authorization (RMA) Form

Return Materials Authorization (RMA)

The following information is required in order to process your request for return of material. This form is not to be used for product repair, warranty or service.

Please contact your JCM area representative for prior approval of this request. Product will not be accepted without an RMA number. Upon submission of this form, a JCM administrative representative will process your request and fax the RMA number to you shortly.

* - Required Fields

BILLING ADDRESS

* NAME

* ADDRESS 1

ADDRESS 2

* CITY

* STATE/PROVINCE

* ZIP/POSTAL CODE

SHIPPING ADDRESS SAME AS BILLING ADDRESS

NAME

ADDRESS 1

ADDRESS 2

CITY

STATE/PROVINCE

ZIP/POSTAL CODE

RETURN INFORMATION

* TECH CONTACT NAME

TELEPHONE

FAX

* E-MAIL

* P.O. / CREDIT CARD #

METHOD OF PAYMENT

NET 30 CREDIT CARD

RETURN SHIP METHOD

GROUND
OVERNIGHT
2 DAY
WILL CALL
OTHER

* ITEMS FOR RETURN

REASON FOR RETURN

PART #	YOUR PART #	PART DESCRIPTION	QUANTITY