edax - RA CRO Request Form

Are you requesting to: Return a part only Repair customer property Replace or exchange a part

Step 1: Bill to Information (info required for non-billable, too)
Name*
Title
Company/Institution*
Divison/Department
Address 1*
Address 2
City*
State/Province*	Abbreviation
Zip/Post Code*
Country*
Phone*
Fax
E-mail*
PO Number (required for all billable request)

Step 2: Ship to Information
(Same as Bill To Info)
Name
Title
Company/Institution*
Divison/Department
Address 1
Address 2
City
State/Province	Abbreviation
Zip/Post Code
Country
Phone*
Fax
E-mail*

If warranty replacement or repair requested provide the following:
EDAX System S/N
OR
Original PO#
OR
Original system Order# (S# or R#)
Item Description*
Serial Number and Part Number and Part Number of item begin returned*
Description of problem with item*
Other Items included in shipment (i.e. cables, software)
Sales Order Number
Invoice Number
*Required Field