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Returns
Returns
Return Authorization Request
Leave this field empty
Acct #:
Date:
Company Name:
Requested by:
Phone #:
Ship Merchandise To:
Fax #:
Address on Account
Email:
This must be a valid email address or you will not receive your RA number!
Other (Leave in Note Section)
MFG
PART #
SN# / ESN#
(if applicable)
PROBLEM
(BE SPECIFIC)
ACTION
NEEDED
(see codes)
Purchase
Date
Inv. #
INS
W
OOW
INS
W
OOW
INS
W
OOW
INS
W
OOW
INS
W
OOW
Codes:
W
= Warranty Repair -
items will be repaired or replaced at PCI’s Discretion
OOW
= Out of Warranty Repair -
Pre-approve $80.00
INS
= Service under Esurion Insurance
NOTES:
By selecting this box and the "
Send Request
" button, I agree to
and understand
PCI's Return Policy
.
required fields
For Questions related to this RA call 800-245-4411
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