Request For RMA Number

                                                     Print and Fax to: (505) 823-1560

This form is used to request authorization for the return of ATA Sensors products under terms of the Product Warranty and Returned Materials Authorization Policy. All information must be filled in, and the form faxed to:
Customer Support Department: (505) 823-1560

As soon as the information is verified, you will receive an authorization signature and number by return fax. A copy of this signed authorization should accompany the returned product.

Customer Name:__________________________________________________________________________

Company: _______________________________________________________________________________

Phone: ______________________________________ Fax: ______________________________________

E-mail: _________________________________________________________________________________

Product Number/ Serial Number: ____________________________________________________________

Statement of Problem (describe fully):________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

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Product should be shipped prepaid in the original container / case with all cables and components. Product will be returned prepaid after repairs. Do not include any parts or accessories that are not part of the original product from ATA Sensors as we cannot be responsible for these.
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Do not write below this line

_______________________________________________________ Date: ____________________________
ATA Authorization Signature

RMA #__________________________________________