33
Terms and Conditions
Appendix E
Embedded and Industrial Computing
RMA Service Request Form
When requesting RMA service, please fill out the following form. Without
this form enclosed, your RMA cannot be processed.
RMA No:
Reasons to Return:
□
Repair(Please include failure details)
□
Testing Purpose
Company:
Contact Person:
Phone No.
Purchased Date:
Fax No.:
Applied Date:
Return Shipping Address:
Shipping by:
□
Air Freight
□
Sea
□
Express
___
□
Others:________________
Item
Model Name Serial Number
Configuration
Item
Problem Code Failure Status
*Problem Code:
01:D.O.A.
02: Second Time
R.M.A.
03: CMOS Data Lost
04: FDC Fail
05: HDC Fail
06: Bad Slot
07: BIOS Problem
08: Keyboard Controller Fail
09: Cache RMA Problem
10: Memory Socket Bad
11: Hang Up Software
12: Out Look Damage
13: SCSI
14: LPT Port
15: PS2
16: LAN
17: COM Port
18: Watchdog Timer
19: DIO
20: Buzzer
21: Shut Down
22: Panel Fail
23: CRT Fail
24: Others (Pls specify)
Request Party
Confirmed By Supplier
Authorized Signature / Date
Authorized Signature / Date
