Active Vision RMA Request Form

A Return Merchandise Authorization (RMA) number issued by Active Vision must accompany all returns. All items returned without an RMA number will be REFUSED. To request a RMA, please fill out and submit the form below and you will recieve a Email with instructions on how-to complete your return. Please fill in all the details, fields left empty or incorrect may cause delays in the RMA process.

Name:		Phone:
Email:

	Product Number	Order Number	Detailed Description of Problem	Qty	Procedure
1.					Refund Repair / Replacement
2.					Refund Repair / Replacement

*I understand the RMA terms and conditions on the previous page, Initials:

Please enter the following code into the box provided: