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SECTION 8—RETURN MATERIALS AUTHORIZATION & ORDER FORM
Stop-Time Measurement Device
RETURN MATERIALS AUTHORIZATION REQUEST FORM
To return material for any reason contact the sales department in our organization at 1-800-922-7533 for an R.M.A.
number. All returned materials shipments must be prepaid. Complete this form and send with material to
5795 Logistics Parkway, Rockford, Illinois 61109. Make sure the R.M.A. Number is plainly identified on the outside of the
shipping container.
Company
Address
City
State
Zip
Phone
Fax
Contact Name
Representative
Items Authorized To Return on R.M.A. No.
Original Invoice No.
Date
Part No. Serial No.
Description
Service Requested:
q
Full Credit
q
25% Restocking
q
Repair & Return
q
Warranty Replacement
Reason for return (describe in detail):
Return Materials Authorized By
Date
ORDER FORM FOR SIGNS AND LITERATURE
This instruction manual references signs and literature available for your machines. This order form is for your convenience
to order additional signs and/or literature as needed. (This order form is part of your installation manual so please make
a copy of it when ordering.)
Company
Address
City
State
Zip
Phone
Fax
Name
Purchase
Order
No.
Date
Part No. Description Quantity Required
KSL-220
Installation Manual
KSL-051
Booklet - “Mechanical Power Press Safety”
FAB
Catalog - “Safeguarding Fabricating Machines”
SFM
Catalog - “Shields For Machinery”
For prices and delivery, please use address, phone or fax number listed on the front cover of this manual.
Your Signature Date
STMIM/ALL500/0119
