ADVANTAGE MEMORY CORP.

RMA REQUEST FORM

Company * 

:

Phone Number * :

area code + phone number (format  xxx-xxx-xxxx)

Fax Number        :

area code + phone number (format  xxx-xxx-xxxx)

:

   Must be a valid e-mail address or you will not 

   receive RMA# and shipping instructions

QTY

     AMC Label(s) - (Must enter all lines from label)

Failure Mode

Select One Customer Cancellation Customer Error D.O.A. Defective No More Info Evaluation Return Field Failure Intermittent Error Stock Balance Sales Error Other

 Action Requested

  Select One * Credit Only * Cross Shipment Re-Work

 * - Within 15 days of invoice

P.O. #

   Invoice #

Failure Mode

Select One Customer Cancellation Customer Error D.O.A. Defective No More Info Evaluation Return Field Failure Intermittent Error Stock Balance Sales Error Other

 Action Requested

  Select One * Credit Only * Cross Shipment Re-Work

 * - Within 15 days of invoice

P.O. #

   Invoice #

Failure Mode

Select One Customer Cancellation Customer Error D.O.A. Defective No More Info Evaluation Return Field Failure Intermittent Error Stock Balance Sales Error Other

 Action Requested

  Select One * Credit Only * Cross Shipment Re-Work

 * - Within 15 days of invoice

P.O. #

   Invoice #

Failure Mode

Select One Customer Cancellation Customer Error D.O.A. Defective No More Info Evaluation Return Field Failure Intermittent Error Stock Balance Sales Error Other

 Action Requested

  Select One * Credit Only * Cross Shipment Re-Work

 * - Within 15 days of invoice

P.O. #

   Invoice #