<%@LANGUAGE="VBSCRIPT"%> Portwell -- Support -- Online RMA Form
 
 
Support
RMA
e-Catalog

Online RMA Application Form
Company
Contact   
Phone   Ext:
Fax   
E-mail *
Address
City Zip Code
State Country
Item 1
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 2
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 3
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 4
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 5
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 6
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item 7
Invoice No. Qty: Part No. Serial No.
Description of Problem
Item8
Invoice No. Qty: Part No. Serial No.
Description of Problem
     
Return for Repair / Replacement
Return for Credit (within 30 days)
  • Remember to fill out this form completely in order to expedite your RMA request.
  • Please include your RMA number on the shipping label when returning the product(s).
  • Please return to the following address:

    • American Portwell Technology
    Att: RMA Dept.
    44200 Christy Street, Fremont, CA 94538
    For Internal
    RMA# Issued by Issue Date (mm/dd/yy)
    Phone (510) 403.3399

    Ext

    		   Fax (510) 403.3184