RMA Request

RMA Request

Please complete all information below.


Company
First Name
Last Name
Title
Email
Website
Type of Company	End User Distributor OEM Contractor
Address 1
Address 2
City
State
Zip
Main Phone Number	- ext
Fax	- ext
Other	- ext (i.e. cell or pager)
Comments
Fixture Type	Recessed Downlight (In Ceiling) Surface Mount Ceiling Fixture Wall Mounted Fixture Sign Light Under Cabinet Desk Lamp Floor Lamp Track Light Landscape Indoor Outdoor Other:
Is a sample of the fixture available?	Yes No
Fixture Manufacturer
Fixture Model
Lamp Information (i.e. lamp mfg./part number)
Has unit been "T" point tested?	Yes No
Hatch model number(s) obtained from the label
Quantity of units in question
Total Units
Product date code(s) (found at bottom or side of label)
Date of installation
Failure mode (i.e. lamp cycling, will not start lamp, etc.)
Name and address of installation
Location hours of operation


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