Returned Material Report (RMR)
This form is for repairs and warranty issues only.
Do not return product for credit on this form.
Account Number
Date:
Attn: Repair Department
1000 Armstrong Drive
Fairmont, MN 56031, USA
Phone: 507-238-4461 / 800-533-0456
Fax: 507-235-8291 / 800-368-2042
Email:
rmr@awtx-itw.com
Expedite this order and I agree to pay the expedite fee.
This area must be complete to properly process your request
Purchase Order/Reference #
Bill To/Company:
Name
Address
City, State, Zip
Contact Name
Phone
Ship To/Customer:
Name
Address
City, State, Zip
Contact Name
Phone
Model #
Serial #
Action Requested:
Parts credit
Recalibration
Non-Warranty Repair
Warranty Repair
Warranty Replace
Exchange Warranty:
(Replacement Sent)
Warranty Sales Order #
Service Exchange Weighline Rail:
Sales Order #
Return Ship Method:
Red (overnight service)
Blue (2nd day service)
Orange (3rd day service)
Ground
Other:
Shipping Account:
Account #
List each item being returned on this RMR. Use Avery Weigh-Tronix
part numbers, if known, or describe each item completely
1.
Quantity
Part #
Description
Failure symptoms or reason for return
2.
Quantity
Part #
Description
Failure symptoms or reason for return
METHOD OF PAYMENT
(
select one
)
Credit Card
C.O.D
(
Note:
C.O.D. has an additional charge of $5.50
)
Please provide the responsible parties contact information for payment:
Contact Name
Phone Number
Email Address
PLEASE NOTE EFFECTIVE FEBRUARY 2, 2015 A STORAGE FEE OF $50 PER MONTH
WILL BE CHARGED TO YOU IF PROMPT PAYMENT IS NOT RECEIVED.
COST ESTIMATE
(
Note:
Check this box if you would like us to call with a cost estimate before proceeding with the repair.
)
TAX EXEMPT
(
Note:
Check this box if you are tax exempt. If tax exempt, please include a copy of your tax exempt certificate.
)
Additional Instructions
Please complete and send a copy of the RMR form along with the product. Keep a copy for your records.
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Avery Weigh-Tronix, LLC