Company*

    Address*

    Compotech contact person

    Compotech contact person e-mail address

    Customer RMA reference

    Customer contact person*

    Customer contact person e-mail address*

    Quantity*

    Part number (if more than one part number, make a separate RMA request for each part number)*

    Part name

    Compotech order number/Delivery date*

    Error description/batch number/date code/other*