General Repair RMA Request Form

The information you are providing below is strictly confidential and will not be sold or redistributed without your authorization. If you have any questions please call Barcode4Less at 847-984-0097

RMA Information
Service Type : Date:
Type : Customer Number :
Existing Customer :
If this equipment was repaired by Barcode4Less within 90days then select YES, otherwise if unsure select NO.
Under Warranty :
Billing Information
First Name: *
Last Name: *
E-Mail:* A RMA confirmation will be sent to this e-mail address.
Company: * * denotes required fields
City: *
State:*   Zip: *
Phone: *   Ext:
Fax: *
Shipping Information (Check to use Billing Information: )
First Name:
Last Name:
State:   Zip:
Phone:   Ext:
•Equipment Information•
Manufacturer: Model: S/N : Problem Description :
•Additional Billing and Shipping Information•
Payment Method: Required for all repairs
Do you wish to add an expedite fee of $35.00 per each repair for faster turn-around (1 day turn around)
     Yes, expedite my repair for an additional $35.00
     No, don't expedite my repair for an additional $35.00
Return Shipping method:  
To pay using credit card please see payment policy
 Items with asterisks represent required inputs. If you have any questions please call Barcode4Less main office at 847-984-0097