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RMA REQUEST FORM - Hikvision

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

Rev 10.16.12 (Effective November 1st, 2012) Page 2 Expiration: An RMA is valid for thirty (30) calendar days after its issuance by Hikvision. Customer must return the product described in the RMA within thirty (30) days or a new RMA will be required.

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