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Part # MCOSM06 Rev 1 (11/03/08) Page 71
Part Number Description Invoice No. Qty Reason for Return Approval Receiver
Customer : _____________________________
Requested By: __________________________
Complete the following details for each item requested to be returned. Fax to 1-800-361-7745
Request For Parts Return Authorization
RGA#
________________________
Request Date:
_______________________
Restocking –
Yes
No
Osetting Order – Yes
No