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Service Form
This form is used for returning products to Newport Corporation.
The user should photocopy and return the completed form to Newport Corporation.
Returning Products
Unused and undamaged products may be returned to Newport within 39 days of the initial invoice date (60 days
outside the USA), but are subject to a 25% restocking fee.
You must first obtain an RA# by calling our Service Department or visiting our web-site at www.newport.com.
Ship the product back to us prepaid in the original or equivalent packaging with the RA# clearly marked on the
outside of the box. Pack carefully to prevent damage. Newport cannot be responsible for any damage occurring
in transit to us and we do not accept products returned without an RA#.
Name _______________________________________________
RETURN AUTHORIZATION # _____________________
Company____________________________________________
(Please obtain prior to return of item)
Address _____________________________________________
Country _____________________________________________
Date ___________________________________________
P.O. Number _________________________________________
Phone Number _________________________________
Item(s) Being Returned:
Model # _____________________________________________
Serial # ________________________________________
Description: ____________________________________________________________________________________________
Reason for return of goods (please list any specific problems) _______________________________________________
________________________________________________________________________________________________________
Please complete the below, as appropriate:
List all control settings and describe problem: _____________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
___________________________________________________________________ (Attach additional sheets as necessary)
Show a block diagram of your measurement system including all instruments connected (whether power is
turned on or not). Describe signal source. If source is a laser, describe output mode, peak power, pulse width,
repetition rate and energy density.
Where is the measurement being performed?
(factory, controlled laboratory, out-of-doors, etc) __________________________________________________________
What power line voltage is used? ____________________________ Variation? __________________________________
Frequency? _________________________________ Ambient Temperature? _____________________________________
Variation? _______________________ °F. Rel. Humidity? _______________ Other? _______________________________
Any additional information. (If special modifications have been made by the user, please describe below).
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Newport Corporation
U.S.A. Office: 800/222-6440
FAX: 949/253-1800
Artisan Technology Group - Quality Instrumentation ... Guaranteed | (888) 88-SOURCE | www.artisantg.com
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