Company Name: *
PO # *
Email address where RMA form should be sent *

Item: *
Part # as it appears on Chicago Tech packing slips and invoices
QTY: *
Root Cause of Problem: *
Serial #(s): *
Serial #'s as they appear on Chicago Tech packing slips and invoices

If there are additional items in your RMA request please enter them below.

Item:
Part # as it appears on Chicago Tech packing slips and invoices
QTY:
Root Cause of Problem:
Serial #(s):
Serial #'s as they appear on Chicago Tech packing slips and invoices

If there are additional items in your RMA request please enter them below.

Item:
Part # as it appears on Chicago Tech packing slips and invoices
QTY:
Root Cause of Problem:
Serial #(s):
Serial #'s as they appear on Chicago Tech packing slips and invoices

If there are additional items in your RMA request please enter them below.

Item:
Part # as it appears on Chicago Tech packing slips and invoices
QTY:
Root Cause of Problem:
Serial #(s):
Serial #'s as they appear on Chicago Tech packing slips and invoices

Fill out the following if you feel any of the items you are requesting a RMA on require more information.

Attach Supporting documentation or pictures
Further Explanation of reason for return