Fluid Components International VORTAB - Manual (Page 15)

VORTAB Flow Conditioner VORTAB ® Company
Doc. No. 06EN003269 Rev. D 15
This page is subject to the proprietary rights statement on the last page
1. Return Customer Information
Returning Company’s Name: _____________________________Phone# __________________________________
Return Contact Name: __________________________________ Fax # ____________________________________
Email Address: ________________________________________________________________________________
2. Return Address
Bill To: _______________________________________ Ship To: _______________________________________
____________________________________________ ______________________________________________
____________________________________________ ______________________________________________
____________________________________________ ______________________________________________
3. Mandatory End User Information
C ontact: ______________________ Company: _____________________________ Country: ________________
4. Return Product Information
Model No: ____________________________________ Customer No(s): _________________________________
Failure Symptoms (Detailed Description Required) : ____________________________________________________
____________________________________________________________________________________________
What Correspondence Was Done Via Phone or Field Visit by VORTAB: _____________________________________
____________________________________________________________________________________________
VORTAB Factory Technical Service Contact: _________________________________________________________
5. Reason For Return  Matching to Flow Meter for Calibration  Damage to Flow Conditioning Internals
 Fit Interference  Built Incorrectly  Credit  Other
6. Payment Via  Faxed Purchase Order  
(Note: A priced quotation is provided for all Non-Warranty repairs after equipment has been evaluated. All Non-Warranty repairs
are subject to a minimum evaluation charge of $250.00)
Factory Return Shipping Address: VORTAB Company
1755 La Costa Meadows Drive
San Marcos, CA 92078-5115
Attn: Repair Department
RA #____________
RA #______________
1755 La Costa Meadows Drive, San Marcos, CA 92078-5115 USA
760-744-6950 / 800-854-1993 / Fax: 760-736-6250
Web Site: www.fluidcomponents.com
E-mail: [email protected]
Return Authorization Request