Company:

Contact:

Address:

    City:    State:    Zip:

    E-mail:   Phone:   Fax:

Model Number: Serial Number:

Invoice Number Invoice Date:

 Please provide a detailed reason for return below:


Repair:        Exchange:        Credit:


       
Please check all items returned with your RMA:

            CPU:    MEMORY:    HARD DRIVE:    FLOPPY:    CD-ROM:    BATTERY:   

AC ADAPTER: POWER CORD:  ORIGINAL BOX:  SOFTWARE:  CARRYCASE:  PCMCIA:  

 NOTES: