12 ABB RMA Form
ABB Inc.
K-TEK Level Products
Industrial Automation
125 E. County Line Road
Warminster PA 18974 USA
Service e-mail: ktek-service@us.abb.com
*** IMPORTANT CUSTOMER NOTICE: PLEASE READ PRIOR TO RETURNING PRODUCTS TO ABB***
Be sure to include the Return Authorization (RA) number on the shipping label or package to the attention: Customer Service. A
copy of this document should also be included with the packing list. ABB wants to maintain a safe work environment for its
employees. In the event, the returned product or material has been in contact with a potentially hazardous chemical, per federal
regulations, the customer must provide evidence of decontamination and the related chemical composition and characteristics. In
order to expedite your return, please include the applicable Material Safety Data Sheets (MSDS) and decontamination tags by
affixing these documents in close proximity to the shipment label for identification purposes. (January 18, 2006)
Return Authorization Form
Customer: Date:
Contact Name: Product:
Contact Email: Serial No:
Contact Phone: Job No:
Contact Fax: Service Rep:
Completed by Customer
Reason
Problem Found:
Action:
Requested:
Is expedited return shipping requested? Yes No
If yes, please provide a purchase order or your shipper’s account number (ex. FedEx or UPS). ABB pays return transport via standard ground shipments only.
If purchase order is issued, a copy of purchase order must be included with return documentation.
Is ABB authorized to repair items determined to be non-warranty? Yes No
If yes, a copy of purchase order must be included with return documentation.
Has product been in contact with any potentially hazardous chemical? Yes No
If yes, documentation product and forward MSDS to ABB, “ATTN: Customer Service”
Return Repaired Product to Address
Shipping Address: Billing Address:
Customer PO: Date:
Account #:
Ship Via:
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