Thermocouple, Thermowell and RTD products from JMS Southeast, Inc


	Received Material Authorization (RMA) Form
	The Received Material Authorization or RMA is here for your convenience. An RMA must be submitted for any items being returned to JMS Southeast, Inc. This enables our Receiving Personnel to receive and distribute the materials to the appropriate person or persons. * All sections of the form must be filled out as indicated. * An assigned RMA number must be on each submitted RMA. * A Sales Representative should be contacted prior to the return of any items.

General Information:

RMA Number *

JMS Contact *

Company Name *

Customer Contact *

JMS Rep

Phone *

Fax

Description or Part # *

Expected Quantity *

Actual Quantity Received *

Date to Arrive *

Date Actually Arrived *

PO Number

WO Number - Old

WO Number - New

Reason for Return (check all that apply):

Customer Misorder

Shipment doesn't match order

Shipping Damage

Sample

Quote

Customer Supplied Products - Customer PO#

Evaluate to determine warranty class

Failure of Product (check all that apply):

N/A

Not Reading

Reads High

Reads Low

Failure Temp

Chemical Environment

Mechanical Failure

Other

Warranty Class (check all that apply):

Repair/Return - NC

Repair/Return - Charge

Return - Credit

Return - No Credit

Other

Calibration - Charge

Calibration - No Charge

N/A

Assignment of Responsibility (check all that apply):

Initial	Final
		Sales
		Manufacturing
		Quality Control
		Shipping
		Purchasing
		Customer Service
		Rep
		Reseller Error
		N/A

Is the item clean (not harmful)? *				yes				no
(If no an MSDS from the shipper is necessary.)

Special Instructions:

Signature

Date

Analysis Results:

Date Needed

Date Received

Signature

Date

Disposition:

Car Number

Signature

Date

* Required field