RMA for a Return:
Return for Credit
Other - explain
    
[Explanation required if Other is selected]
Level of Urgency:High        Medium       Low
Contact Information [fields in red are required entries]
Company Name
Contact Name
Billing Address 1
Billing Address 2

City
State              Zip
Telephone    ext
Fax #
email
Please make sure the email address you entered is 100% accurate!
ITEM FOR RETURN - #1
Quantity
Manufacturer
Part Number or Model Number
Product Description
Serial Number
[or N/A if none]
Approximate Date of Purchase
Your Original PO# 
Invoice #
[if known]

Reason
for
Return



If Other is selected, please explain:
Note: Restocking fees will be quoted based on:
  • condition of item and use of original packaging
  • manufacturer's return policy
  • age of item and date purchased
  • marketability of item - stock or non-stock

Only items purchased from Cross Automation may be returned for credit
Cross Automation retains the right to refuse return of products 90 days after invoice date.

Comments:

Please review your data input, then go to the bottom of this page for form submittal OR proceed with Item #2

ITEM FOR RETURN - #2
Quantity
Manufacturer
Part Number or Model Number
Product Description
Serial Number
[or N/A if none]
Approximate Date of Purchase
Your Original PO# 
[if known]
Invoice #
[if known]

Reason
for
Return



If Other is selected, please explain:
Note: Restocking fees will be quoted based on:
  • condition of item and use of original packaging
  • manufacturer's return policy
  • age of item and date purchased
  • marketability of item - stock or non-stock

Only items purchased from Cross Automation may be returned for credit
Cross Automation retains the right to refuse return of products 90 days after invoice date.

Please review your data input, then go to the bottom of this page for form submittal OR proceed with Item #3

ITEM FOR RETURN - #3
Quantity
Manufacturer
Part Number or Model Number
Product Description
Serial Number
[or N/A if none]
Approximate Date of Purchase
Your Original PO# 
[if known]
Invoice #
[if known]

Reason
for
Return



If Other is selected, please explain:
Note: Restocking fees will be quoted based on:
  • condition of item and use of original packaging
  • manufacturer's return policy
  • age of item and date purchased
  • marketability of item - stock or non-stock

Only items purchased from Cross Automation may be returned for credit
Cross Automation retains the right to refuse return of products 90 days after invoice date.


PLEASE REVIEW ALL ITEMS PRIOR TO SUBMITTING FORM.