RMA

Condux Return Merchandise Authorization Form

Claim Number

Request Type(Required)

Name(Required)

First Last

Company Name(Required)

Email(Required)

Phone(Required)

Distributor Company Name(Required)

Distributor's Name(Required)

First Last

Distributor's Email(Required)

Distributor's Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Describe the Issue or Problem with the Equipment(Required)

Serial Number/VIN (if Applicable)

Photo of Sales Receipt(Required)

Drop files here or

Max. file size: 256 MB.

Photo of Product(Required)

Drop files here or

Max. file size: 256 MB.