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Government Products - Repair Request


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	To receive a Return Materials Authorization (RMA) Number to return your Symmetricom product for repair, please provide us with the following information:
*	Technical Contact Name
*	Company
*	Phone
	Fax
*	Email
	Billing Address:
*	Attention
*	Number/Street
	City
*	State/Province
*	Zip / Postal Code
*	Country
	The Product Information:
*	Product Model / Description
	Symmetricom Part Number
*	Serial Number
*	Brief description of failure or problem symptoms
	Attachments related to the repair
	Was this unit Dead on Arrival/non-functional at installation? Yes No
	Have you spoken to Technical Support on this issue? Yes No
	Address to which you would like repaired unit returned:
	Attention
	Street Address
	Street Address (Cont)
	City
	State
	Zip / Postal Code
	Country
	For non-USA customers, additional information required to process international repair requests
	End User Name
	Street Address
	Street Address (Cont)
	City
	State/Province
	Zip/Postal Code
	Country
	If product to be repaired is any model of Cesium Clock or cesium standard, provide original U.S. Export License Number under which you purchased the item.