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(), 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/Province:
* 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

Please use these additional fields if you have more than one serial number to provide (otherwise, please leave blank)

*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.