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26
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
RMA
Number
*If
known.
Serial
Number
Date
of
Purchase*
Contact
Information
for
Repair
Contact
Name
Company
Phone
Number
E
‐
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.)
Contact
me
for
credit
card
information
(For
security
purposes,
do
not
list
credit
card
information
on
this
form..)
Reference
PO#