Appendices  41
7.5  Appendix C – Return Material Authorization Request 
Newport Corporation, Returns Department, 1791 Deere Avenue, Irvine, CA 92606 
Tel:  800-222-6440         FAX:  949-253-1479   
Email:  rma.service@newport.com   Web: www.newport.com 
 
Newport RMA #:   R            (assigned by Newport Corporation)
Name:     Date: 
  
Telephone #:      Fax: 
  
Email:    
Company Name:   
Ship to Address Line 1: 
 
Ship to Address Line 2: 
 
Ship to City:   
Ship to Country:    State:    Zip Code:   
 
YES   NO 
If Warranty Repair or Replace, complete this section
: 
  Date of your original purchase. 
C            Original Newport sales Order number (begins with C). 
  Your Original Purchase Order number. 
YES    NO  Has this product been used? 
YES    NO  Would you like a refurbished replacement if available? 
YES    NO  Is this product being returned for Credit only? 
Credit only is not an option for Newport Warehousing Divisions. 
YES   NO 
If Non-Warranty Repair or Replace, complete this section
: 
  Purchase Order number (approval required before invoicing) 
YES    NO Detector Calibration (will include functional check of power meter) 
YES    NO  Power Meter Calibration 
What Company name should be on the Calibration Certification?             
YES    NO  Would you like to be quoted a refurbished replacement if available? 
 
     PRODUCTS BEING RETURNED (LIST VALID NEWPORT PART NUMBERS) 
Part Number  Description  S/N Qty Declared value 
        $ 
        $ 
        $ 
        $ 
        $ 
Totals 
  $ 
Reason for Return and detailed explanation of problem: