This Form is for Defense RMA ONLY

Note: All fields marked * are required.
General Information
RMA Type (select one)
Demonstration unit return    
Evaluation unit return    
Damaged in shipment    
Technical problem (Please be sure to complete Technical Report section of form)
Customer Related Equipment    
Other (Example: "ordered wrong model")
Special Requirements (check if appropriate)
DPAS Rated (select Defense Priorities and Allocations System classification if appropriate)
If "Other" is selected, please provide:
* ITAR (handling under International Traffic in Arms Regulations)
Yes No Note: SSDs with sensitive ITAR data CANNOT be accepted.
Is a Certificate of Compliance required with the return of the unit(s)?
(A C of C with PO#, Serial Number(s), and RMA# and signed by Quality will be issued)
Yes No
 
Customer Contacts
Check here if the Technical Contact is the same as the Business Contact. Clear
Business Contact
For questions regarding invoicing and shipping
* Name:
* Email:
* Phone:
Fax:
   
Company Information
Check here if Return Shipment Address is same as the Billing Address. Clear
Return Shipment Address      
* Company Name:
* Address Line 1:
Address Line 2:  
* City:
State (US-only):  
Region (Non-US):  
* Country:
* Postal Code:
     
Purchasing Information
Date Purchased: (Format: mm/dd/yyyy)
* Original PO #:
Original Invoice #:    
If Purchased from Other Source, please provide: Purchased From:
     
Unit Information
Number of Units on this RMA:
Please include only one model per RMA. Multiple serial numbers of the same model are okay.
* SMART Model Firmware * Part Number * Serial Number Tech Code
#1
*Additional Serial Number: #2  
*Additional Serial Numbers:
#2 #3
*Additional Serial Numbers: #2 #3 #4
*Additional Serial Numbers: #2
#5
#3 #4
*Additional Serial Numbers: #2
#5
#3
#6
#4
*Additional Serial Numbers: #2
#5
#3
#6
#4
#7
*Additional Serial Numbers: #2
#5
#8
#3
#6
#4
#7
*Additional Serial Numbers: #2
#5
#8
#3
#6
#9
#4
#7
*Additional Serial Numbers: #2
#5
#8
#3
#6
#9
#4
#7
#10
*Additional Serial Numbers: #2
#5
#8
#11
#3
#6
#9
#4
#7
#10
*Additional Serial Numbers: #2
#5
#8
#11
#3
#6
#9
#12
#4
#7
#10
 
If you checked RMA Type = Technical Problem, complete as much of the Technical Problem Report as possible. If not, you can finish your submission by using the Submit button at the end of this form.

End of Defense RMA Submission Form