Metal Samples MS2701E, Operator'S Manual, Page: 20 / 25

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C. Instrument Repair Form
This form may be photocopied for use when returning an instrument to Metal Samples for repair.
Please fill in all known information and enclose a copy of the completed form with the instrument.
General Information
Model
Number
Serial
Number
RMA
Number
Date of
Purchase*
*If known.
Contact Information for Repair
Contact
Name Company
Phone
Number
E ‐ mail
Address
Return Shipping Information
Recipient
Name* Company*
Return
Address
*If different than above.
Reason for Return. (Provide as much detail as possible. Attach additional pages if required.)
Invoice Instructions (For non ‐ warranty repairs)
Invoice me for the repair
(Requires an open account with Metal samples.)
Reference
PO#
Contact me for credit card information
(For security purposes, do not list credit card information on this form..)