SMC100CC & SMC100PP
Service Form
Name: __________________________________________________
Company: _______________________________________________
Address: ________________________________________________
Country: ________________________________________________
P.O. Number: ____________________________________________
Item(s) Being Returned: ____________________________________
Model#: _________________________________________________
Description:_________________________________________________________________________________________________________
Reasons of return of goods (please list any specific problems): _________________________________________________________________
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EDH0312En1010 – 10/11
Single-Axis Motion Controller/Driver for DC or Stepper Motor
Return authorization #: _____________________________________
(Please obtain prior to return of item)
Date: ___________________________________________________
Phone Number: ___________________________________________
Fax Number: _____________________________________________
Serial #:_________________________________________________
15
Your Local Representative
Tel.: ___________________
Fax: ___________________