CUSTOMER NAME:

CONTACT:

TELEPHONE:

CELL #:

EMAIL:

ADDRESS:(Pls Don't Use"'")

RETURN ADDRESS IF DIFFERENT FROM ABOVE:

PRODUCT NAME:

QUANTITY:

SERIAL #:

INVOICE DATE:

Pick a date

PURCHASE FROM:

REASON OF RETURN:

CONDITION OF RETURN:

SUBMIT DATE:

Pick a date

SIGN:

SHIPPING INFORMATION

Customer are responsible for inbound freight charges and filling out RMA form completely

AES will not accept COD shipments

AES will pay the standard ground delivery charges for returning your product following repair/replacement

Return freight charges will apply to out of warranty repairs. Products which require service not covered by the warranty (damaged units)will result in notification to the customer prior to any action

Canada

Acura Embedded Systems

SUITE# 101-17825 64th Avenue

Surrey, BC, Canada

V3S 1Z3

SUGGESTED SHIPPING INSTRUCTIONS:

For Transportation charges: Mark the carrier Bill of lading as "prepaid" or Bill "Sender"

For payment of Duties/Taxes: Mark the carrier Bill of lading or Airbill as Bill "Sender"

All RMA shipments must be accompanied by a PO# or Commercial Invoice

USA Customer shipping to Surrey: Commercial Invoice must contain the following statement:

"Defective Parts being returned for repair or replacement"

Commercial Invoice must reference the following:

RMA number:

Product Name:

Unit Value - (Approximate Value for custom purpose only)

Country of origin: Canada

Packing Slip:(Noting all components, pieces and loose items)