Fluid Components International FS10A - Manual (Page 50)

FS10 Series
48 Fluid Components International LLC
1. Return Customer Information
Returning Company’s Name: _____________________________Phone# __________________________________
Return Contact Name: __________________________________ Fax # ____________________________________
Email Address: ________________________________________________________________________________
2. Return Address
Bill To: _______________________________________ Ship To: _______________________________________
____________________________________________ ______________________________________________
____________________________________________ ______________________________________________
____________________________________________ ______________________________________________
3. Mandatory End User Information
C ontact: ______________________ Company: _____________________________ Country: ________________
4. Return Product Information
Model No: ____________________________________ Serial No(s): ____________________________________
Failure Symptoms (Detailed Description Required): ____________________________________________________
____________________________________________________________________________________________
What Trouble Shooting Was Done Via Phone or Field Visit by FCI: _________________________________________
____________________________________________________________________________________________
FCI Factory Technical Service Contact: _____________________________________________________________
5. Reason For Return  Sensor Element  Electronics  As Found Testing  Credit
 Recalibrate (New Data)  Recalibrate (Most Recent Data)  Other
(Note: A new Application Data Sheet (ADS) must be submitted for all recalibrations and re-certifications)
6. Payment Via  Faxed Purchase Order  
(Note: A priced quotation is provided for all Non-Warranty repairs after equipment has been evaluated. All Non-Warranty repairs
are subject to a minimum evaluation charge of $250.00)
Factory Return Shipping Address: Fluid Components International LLC
1755 La Costa Meadows Drive
San Marcos, CA 92078-5115
Attn: Repair Department
RA #____________
RA #______________
1755 La Costa Meadows Drive, San Marcos, CA 92078-5115 USA
760-744-6950 / 800-854-1993 / Fax: 760-736-6250
Web Site: www.fluidcomponents.com
E-mail: [email protected]
Return Authorization Request