Thermotek, Inc.

RMA REQUEST

In order to receive your RMA number in a timely manner, please fill out the form below with as much information as possible.

If you wish, you can request an RMA by fax. Click here for a printable version of this form.

Required items are marked with a red asterisk. *

Company & Billing Information
Company:

*Bill To:

*Bill To Phone:

*Ship To Address:

*City:

*State:

*Zip Code:

Country:

Ship To Phone:

Purchase Order:

Unit Information
*Model:

*Serial Number:
(found on back plate of unit)

Revision:
(found on back plate of unit)

*Describe Problem:

Contact Person
*Name:

*Phone:

Fax:

*E-mail:

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