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Return Material Authorization Form
RMA Number/Repair Order __________________
Windstream Power LLC
445 Long Point Road
North Ferrisburgh, VT 05473
Phone 802-425-3435 Fax 802-425-2896
Date: _________________________________
WSP Contact Name: ____________________________
Customer Name and Address:
______________________________________
Cust. Contact Name: ____________________________
______________________________________
______________________________________
Product Type __________________________________
Phone Number: _________________________
Part Number: __________________________________
Fax Number: ___________________________
Serial Number:_________________________________
What type of device was being powered? ______________________________________________________
What other Windstream Power product(s) were also being used? ___________________________________
_________________________________________________________________________________________
What other non-Windstream Power device(s) were also being used? ________________________________
_________________________________________________________________________________________
Reason for Return:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Signed: _____________________________________
THIS DOCUMENT MAY BE REPRODUCED