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RETURN SHEET
Company Name
Contact Name
Telephone Number
Approximate Usage (hours)
Problems Encountered
Check One:
q
Repair
Do you wish to be contacted before repairing
q
Yes
q
No
q
Return
Contact National if a loaner is needed
Return Authorization Number
Date
Customer Number
Purchased From
REQUIRED
, contact National
INTERNAL USE ONLY
Date Received
Unit Serial Number
Subject To Warranty
if known
if not directly from National
