FED (E2) 12/2014
page 53/55
13.2 For units in North America and Central America
Product Return Authorization Request
Please complete this form and the Customer Decontamination Declaration (next 2 pages) and attach the
required pictures.
E-mail to: [email protected]
After we have received and reviewed the complete information we will decide on the issue of a RMA
number. Please be aware that size specifications, voltage specifications as well as performance
specifications are available on the internet at
Take notice of shipping laws and regulations.
Please fill:
Reason for return request
Duplicate order
Duplicate shipment
Demo
Page one completed by sales
Power Plug / Voltage
115V / 230 V / 208 V / 240V
Size does not fit space
Transport Damage
Shock watch tripped?
(pictures)
Other (specify below)
_____________________
Is there a replacement PO?
Yes
No
If yes -> PO #
If yes -> Date PO placed
Purchase order number
BINDER model number
BINDER serial number
Date unit was received
Was the unit unboxed?
Yes
No
Was the unit plugged in?
Yes
No
Was the unit in operation?
Yes
No
Pictures of unit attached?
Pictures of Packaging
attached?
Yes
No
Yes
No
Pictures have to be attached!
Customer Contact Information
Distributor Contact Information
Name
Company
Address
Phone
