Testing RMA Request

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Complete all required fields of the form.
Are You a Home Owner or Wholesaler?
Name *
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Last
Company Name
Address *
City *
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Zip/Postal Code *
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Phone # *
Format: (123) 456-7890
Email *
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Product Return Information

4-Digit GFI# - (If unknown, you may perform a search on our website.) Only DH Model compressors and evaporator coils use 7-digit numbers.
Original Receipt / PO #:
If replacement part has already been ordered, list new Receipt / PO #
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date:
Reason for Return:*
Quantity:
First Item: Comments:

I am returning a second product: Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Second Item: Comments: *

I am returning a third product: Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Third Item: Comments: *

I am returning a fourth product: Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Fourth Item: Comments: *

I am returning a fifth product: Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Fifth Item: Comments: *