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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EDH0209En2020 – 04/13
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 #: _________________________________________________
55
Your Local Representative
Tel.: ___________________
Fax: ___________________