RMA Request Form

Step 1 of 4

RMA (Return Material Authorization) Request
Please complete the following four steps to accurately process your RMA request.

1. AGENCY INFORMATION: Where BI Incorporated should return repaired/replaced equipment.

Date(Required)

Agency Name(Required)

Customer/Agency Number(Required)

Contact Name(Required)

Hidden

Agency Address(Required)

Street Address Address Line 2 City State ZIP Code

Street Address(Required)

Address Line 2

City(Required)

State(Required)

ZIP Code(Required)

Phone Number(Required)

Email(Required)

FedEx Information:

Fedex Information(Required)

Agency will contact

BI will contact for ground pick-up

BI will contact for express pick-up

If you selected BI to contact, complete the information below:

Pick-up Address(Required)

Street Address Address Line 2 City State ZIP Code

Special Instructions

Total Number of Boxes

FedEx Receipt Number

Select + at the right to add more fields.

For non-warranty customers, BI will fax an assessment with an accurate invoice amount for repair. For customer-owned equipment that is not under warranty, a minimum $50 per unit charge will be applied for all equipment returned for estimate—even if no repair is authorized (charge does not apply to BI-owned equipment or leased equipment under warranty).

This field is for validation purposes and should be left unchanged.

RMA Request Form

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