MPH Industries
316 E. 9th Street
Owensboro, KY 42303
Phone: (888) 689-9222
Fax: (270) 685-6288
Email: info@mphindustries.com
Return Material Authorization Form
Complete all sections of this form where applicable and include a printed copy of the accepted page OR of the confirmation email you receive with the item being returned. A restocking fee may be applied for returned merchandise.
Unit Information
Model:
(Bee III, TrueView PLUS, etc.)
(*required)
Serial Number:
(*required)
***An Incorrect or false Serial Number may result in the product being returned unrepaired***
Address Information
Bill To Address
Name:
(*required)
Attention:
Address 1:
(*required)
Address 2:
City:
(*required)
State:
(*required)
Zip Code:
(*required)
Country:
Ship To Address
Shipping Address Same As Billing Address
Name:
(*required)
Attention:
Address 1:
(*required)
Address 2:
City:
(*required)
State:
(*required)
Zip Code:
(*required)
Country:
Problem Description Information
Reason for Return: (Please be as specific as possible)
(*required)
NOTE -
If you are sending an item in for repair, please give a detailed description of the problem. Please list any special instructions that you may have concerning this return.
characters remaining.
Repair Authorization
(*required)
Warranty Repair
I Authorize ALL Repairs
I Authorize Repairs Up To:
$
Purchase Order Required?
No
Yes
Purchase Order Number:
(If applicable, fax a copy of the Purchase Order to Customer Service at (270) 685-6288 or email to info@mphindustries.com.)
Estimate Information
(*required)
I DO NOT require an estimate regardless of cost
I DO require an estimate regardless of cost
Send estimate to:
Contact Person:
Phone:
Fax:
Email:
An evaluation fee will apply to estimates that are not repaired. ($50.00 for Radars, $100.00 for In-Car Video Systems)
Authorization
Email a copy of this RMA To:
Customer Number (if known):
Authorized By:
(*required)
Phone:
(*required)
Please verify all information you have entered is correct.
When finished, hit the Submit button below to submit this RMA.