RETURN MATERIAL AUTHORIZATION FORM

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Reason for RMA (please check one):
Domestic RMA:

 Purchased from Nivisys and under warranty. (Product to be shipped in on the sending parties account. Nivisys will ship product back to sender on Nivisys’ account)
 (Non-Warranted Items billed $95.00 per unit Evaluation Fee)
 Not purhased from Nivisys

International RMA:

 Purchased from Nivisys and under warranty. DSP-5. (Product to be shipped in on the sending parties account. Nivisys will ship product back to sender on Nivisys’ account)
 DSP-5. (Non-Warranted Items billed $95.00 per unit Evaluation Fee)
 Demo Return to have repaired or replaced. DSP-73

Product Details

Item: Part Number: Description: Serial No: Qty:
1