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EMP: Information Request

If you have found a problem with your product supplied by EMP and would like to return for replacement or credit, please fill out the form below. EMP will review your request and contact you to discuss next steps in the process. Please provide as much information as possible so EMP can determine how to handle the RMA request.

Company Name*:
Contact Name*:
Address*:
City*:
State/Province*:
Zip/Postal Code*:
Country*:
Email Address*:
Phone Number*:
Mobile Number:
Fax Number:
Previous EMP Contact:
Case Number:
Comments:
Purchase Date:
Purchase Order #:
EMP Invoice #:
Failed Part Number*: Failed Serial Number*:
Kit Part Number: Kit Serial Number:
Replacement Needed?* Yes No
If yes, please specify one of the two options below:
Before Warranty Review1
After Warranty Review
Comments:
1 Note: If shipment of replacement part is requested before suspect part is processed for warranty coverage, a purchase order for the new part is required and an invoice will be generated. After analysis is performed, customer may be credited.
Description of failure, troubleshooting process, as well as any failure codes revealed by the system. For mini-Hybrid (MH8) kit, please attach a history download if available.
If not a failure, what is the reason for return?
Attachment 1:
Attachment 2: