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RMA Request Form
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RMA Request Form

* = Required fields.

Customer Information

Customer Name: *
Requested by (Contact): *
Location:
Ship to Address: *
Phone No: *
E-mail Address: *
Region: *

Severity/Priority

Critical Major Minor Feature Request Request Information

Failed During Install * Failed In-Service *

How Long In-Service? *

Provide a Detailed Description of the Problem(s): *

What are the alarms present in the system? *

What are the environmental/working conditions of the unit (Env. Temperature, Indoor or Outdoor, Interface equipment, etc)? This will assist in Root Cause Analysis.

Description

Model Name:
Serial Number(s): *
Software Version:
Hardware Revision:
RMA no. (If Available):

In case of RMA give details of

Symptom:
Failure Mode:

For inquiries outside North and South America, please email Actelis Technical Support at: Intl_support@Actelis.com.

For all other inquiries, please email Actelis Technical Support at: techsupport@actelis.com or call in the USA (866) 228-3547 or (510) 545-1071

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