LUDECA | Service Form

Incoming Repair Notice

repair

SHIP TO: Att'n: Service Department LUDECA, INC. 1425 NW 88th Avenue Doral, FL 33172 Fax: (305) 468-1908 repair@ludeca.com
INCOMING REPAIR NOTICE
Required fields are noted with an asterisk (*). If info for a required field is not available, please type in N/A. We require that this form be sent to us prior to shipment. Please send this form by clicking on the 'Submit' button on the bottom on the form. Once you have submitted this Incoming Repair Notice, please ship your System or component to us. note that we do not issue/need an RMA number.
Date*
Company*		Plant*
Address*		City*
State*		Zip*

Contact1*		Phone1*
Fax1*		E-mail1*
Are you the USER for the below selected tool?: Yes No
Contact2		Phone2
Fax2		E-mail2
Are you the USER for the below selected tool?: Yes No
PO No.
Product*		Serial No.*

Customer's Problem*:

Comments:

By*:
This incoming repair notice will be kept on file for 30 days, after which time you need to submit a new one.
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INCOMING REPAIR NOTICE