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Appendix G
RMA Service Request Form
When requesting RMA service, please fill out the following form. Without
this form enclosed, your RMA cannot be processed.
RMA No:
Company:
Phone No.
Fax No.:
Return Shipping Address:
Shipping by:
Air Freight
Others:________________
Item
Model Name
Serial Number
Item
Problem Code Failure Status
*Problem Code:
01:D.O.A.
07: BIOS Problem
02: Second Time
08: Keyboard Controller Fail
R.M.A.
09: Cache RMA Problem
03: CMOS Data Lost
10: Memory Socket Bad
04: FDC Fail
11: Hang Up Software
05: HDC Fail
12: Out Look Damage
06: Bad Slot
Request Party
Authorized Signature / Date
Embedded and Industrial Computing
Reasons to Return:
Repair(Please include failure details)
Testing Purpose
Contact Person:
Purchased Date:
Applied Date:
Sea
Express
___
Configuration
13: SCSI
14: LPT Port
15: PS2
16: LAN
17: COM Port
18: Watchdog Timer
Confirmed By Supplier
Authorized Signature / Date
Terms and Conditions
19: DIO
20: Buzzer
21: Shut Down
22: Panel Fail
23: CRT Fail
24: Others (Pls specify)
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