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Home>Return Material Authorization

RMA (Return Material Authorization) REQUEST FORM

No work on repairs can be started until full payment is received. Any units submitted for repair and not paid for 30 days after submission will become the property of PTEK 

*Denotes Required Information

Name
Company
Address
This is where we will ship the repaired unit to (no PO Boxes)
City
State
(2 character abbreviation)

Zip Code*
Phone

FAX 

E-Mail*
Product
Serial Number*
Insurance Value We should use to return the repair to you?*
All packages are insured by UPS for $100 at no cost if that is OK enter $100
Insurance Charges  
$100.01 - $300 $15 minimum
$300.01 - $50,000 $15 + $0.40 per $100 of value

Fault reported or special instructions
For example, how do you want this shipped back to you if not by UPS ground (our default)?
Characters Left

Please note in warranty returns with no fault will be charged $150 service fee plus return shipping
I have read and agree to the above terms and those on our terms and conditions page



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