RMA REQUEST FORM

908 Canada Court City of Industry, CA 91748 RMA REQUEST form PLEASE FILL form OUT COMPLETELY RMA #: .. DATE REQUEST : .. *TECH ID #: .. *Dealer Code #: .. (*Please choose either Tech ID or Dealer Code to fill in.) PURCHASE FROM: .. YOUR NAME: .. YOUR PHONE: .. YOUR COMPANY NAME: .. hikvision WILL RETUR ITEM(S) TO: YOUR ADDRESS: .. ATTN to: .. STATE: .. ZIP: .. YOUR PHONE: .. YOUR FAX: .. QTY Model Number # Serial Number # (Must be complete & accurate for us to process your REQUEST ) Description of problem (Failure to include a detailed description will result in RMA REQUEST to be auto-declined) REQUEST TYPE: (Please cross out box) Return for Repair Return for Credit Customer Comments: NOTE: ** PACKAGES WITHOUT RMA NUMBER ON THE BOX WILL NOT BE ACCEPTED ** ENCLOSE A COPY OF THIS form IN THE PACKAGE AND SEND ALL RETURNS TO: hikvision USA, Inc.

Rev 10.16.12 (Effective November 1st, 2012) Page 1 HIKVISION USA RMA POLICY Document Purpose and Scope: This document addresses return policies applicable to the products purchased by customers of Hikvision USA ("Customers") that are returned to

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