| Request
for Repair - RMA or Quote: |
Request an RMA
for Repair
Request a
Repair Quote |
| Level
of Urgency:High
Medium
Low |
| Contact
Information [fields
in red
are required entries] |
| Company
Name |
|
| Contact
Name |
|
Shipping
Address 1
Shipping Address 2 |
|
City
State |
Zipcode |
Billing
Address 1
Billing Address 2 |
|
| Telephone |
ext |
| Fax
# |
|
| email |
Please make sure the email address you
entered is 100% accurate!
|
|
Shipping
Method
Shipping Service Level
|
If other is
selected, please explain:
If other is
selected, please explain:
|
|
Shipping
Method Account
Number |
This is your account # with UPS, FedEx,
etc. Otherwise, we will prepay & add appropriate freight costs to
your invoice.
|
|
Payment
Method
|
If you currently do not have an open account
with Cross Automation, credit card or cash in advance is required. |
|
Purchase
Order #
|
(not required for Quote) |
| There are additional charges for rush
or expedited repairs and rapid-turnaround services.
The eligibility of warranty repairs are determined by the
manufacturer. Evaluation and "No Problem
Found" charges may apply. |
| ITEM
FOR REPAIR - #1. ALL ENTRIES REQUIRED. |
|
Level of
Repair Service |
|
| Manufacturer |
|
| Part
or Model Number |
|
| Product
Description |
|
Serial
#
[or N/A if none] |
|
|
Description
of failure or problem, symptoms, other comments |
|
|
Please
review your data input, then go to the
bottom of this page for form submittal OR proceed with Item #2 |
| ITEM
FOR REPAIR - #2 |
|
Level of
Repair Service
|
|
| Manufacturer |
|
| Part
or Model Number |
|
| Product
Description |
|
Serial
#
[or N/A if none] |
|
|
Description
of failure or problem, symptoms, other comments |
|
|
Please
review your data input, then go to the
bottom of this page for form submittal OR proceed with Item #3 |
| ITEM
FOR REPAIR - #3 |
|
Level of
Repair Service
|
|
| Manufacturer |
|
| Part
or Model Number |
|
| Product
Description |
|
Serial
#
[or N/A if none] |
|
|
Description
of failure or problem, symptoms, other comments |
|