When requesting RMA service, please fill out this RMA Service Request Form.
Without this form your RMA will be REJECTED!!!
RMA No: Reasons to Return: □ Repair(Please include failure details) □ Testing Purpose
Company: Contact Person:
Phone No. Purchased Date:
Fax No.: Applied Date:
Return Shipping Address:
Shipping by: □ Air Freight □ Sea □ Express □ Others:
Item Model Name Serial Number Configuration
Item Problem Code Failure Status
*Problem Code:
01:D.O.A.
02: Second Time R.M.A.
03: CMOS Data Lost
04: FDC Fail
05: HDC Fail
06: Bad Slot
07: BIOS Problem
08: Keyboard Controller Fail
09: Cache RMA Problem
10: Memory Socket Bad
11: Hang Up Software
12: Out Look Damage
13: SCSI
14: LPT Port
15: PS2
16: LAN
17: COM Port
18: Watchdog Timer
19: DIO
20: Buzzer
21: Shut Down
22: Panel Fail
23: CRT Fail
24: Others (Pls
specify)
Request Party
Confirmed By Supplier
Authorized Signatures / Date Authorized Signatures / Date