RMA REQUEST FORM
This form will assist you in returning your POSIFLEX product. Note that all required fields (*) must be completed in order to avoid delays. You will receive an assigned RMA number and return information upon receipt and validation of information provided. Do not return your product prior to receiving a valid RMA number. Packages without valid RMA numbers will be refused.

* Required field

*Company Name:	Required field!3 to 50 characters only!3 to 50 characters only!
*Contact Name:	Required field!3 to 50 characters only!3 to 50 characters only!
*Email:	Required field!Invalid format!
*Telephone:	Required field!Invalid format!
*Address:	Required field!3 to 50 characters only!3 to 50 characters only!
	50 characters maximum!
*City:	Required field!3 to 50 characters only!3 to 50 characters only!
*State, Country:	Alaska, USA Alabama, USA Arkansas, USA Arizona, USA California, USA Colorado, USA Connecticut, USA District of Columbia, USA Delaware, USA Florida, USA Georgia, USA Hawaii, USA Iowa, USA Idaho, USA Illinois, USA Indiana, USA Kansas, USA Kentucky, USA Louisiana, USA Massachusetts, USA Maryland, USA Maine, USA Michigan, USA Minnesota, USA Missouri, USA Mississippi, USA Montana, USA North Carolina, USA North Dakota, USA Nebraska, USA New Hampshire, USA New Jersey, USA New Mexico, USA Nevada, USA New York, USA Ohio, USA Oklahoma, USA Oregon, USA Pennsylvania, USA Rhode Island, USA South Carolina, USA South Dakota, USA Tennessee, USA Texas, USA Utah, USA Virginia, USA Vermont, USA Washington, USA Wisconsin, USA West Virginia, USA Wyoming, USA Alberta, Canada British Columbia, Canada Manitoba, Canada New Brunswick, Canada New Foundland, Canada Northwest Territories, Canada Nova Scotia, Canada Ontario, Canada Prince Edward Island, Canada Quebec, Canada Saskatchewan, Canada Yukon Territories, Canada
*Zip / Postal Code:	Required field!5 to 10 characters only!5 to 10 characters only!
*Address Type:	Commercial Residential

Alternate Shipping Address (if different from above).

Please note that Company Name or Contact Name must be entered in order for the alternate shipping address to be recognized by our system.

Company Name:	50 characters maximum!
Contact Name:	50 characters maximum!
Telephone:	Invalid format!
Address:	50 characters maximum!
	50 characters maximum!
City:	50 characters maximum!
State, Country:	Alaska, USA Alabama, USA Arkansas, USA Arizona, USA California, USA Colorado, USA Connecticut, USA District of Columbia, USA Delaware, USA Florida, USA Georgia, USA Hawaii, USA Iowa, USA Idaho, USA Illinois, USA Indiana, USA Kansas, USA Kentucky, USA Louisiana, USA Massachusetts, USA Maryland, USA Maine, USA Michigan, USA Minnesota, USA Missouri, USA Mississippi, USA Montana, USA North Carolina, USA North Dakota, USA Nebraska, USA New Hampshire, USA New Jersey, USA New Mexico, USA Nevada, USA New York, USA Ohio, USA Oklahoma, USA Oregon, USA Pennsylvania, USA Rhode Island, USA South Carolina, USA South Dakota, USA Tennessee, USA Texas, USA Utah, USA Virginia, USA Vermont, USA Washington, USA Wisconsin, USA West Virginia, USA Wyoming, USA Alberta, Canada British Columbia, Canada Manitoba, Canada New Brunswick, Canada New Foundland, Canada Northwest Territories, Canada Nova Scotia, Canada Ontario, Canada Prince Edward Island, Canada Quebec, Canada Saskatchewan, Canada Yukon Territories, Canada
Zip / Postal Code:	5 to 10 characters only!5 to 10 characters only!
Address Type:	Commercial Residential

Remember My Contact Information (This computer only)

*Type of RMA Request:	Select One Warranty Repair Post Warranty Repair Cross-Shipment Return For Credit Advance Exchange Advance Exchange with Onsite
*Support Ticket ID:	Required field!3 to 15 characters only!3 to 15 characters only!

Enter up to 10 serial numbers. If a serial number is entered, a reason for return and type of item being returned must also be entered.

Serial Number

Reason for Return

Item Returned

1			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
2			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
3			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
4			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
5			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
6			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
7			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
8			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
9			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other
10			Select One Terminal/System LCD HDD (Hard disk) Touch Panel Memory Power Supply Pole Display Printer Cash Drawer MSR/Card Reader Other

*Enter security code (black characters only):

Required field!Must be 5 characters in length.Must be 5 characters in length.