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LIATA COMPUTER CO., LTD CUSTOMER RMA REQUEST FORM 3611 Mavis Rd. Unit 16 & 17                                      REPAIR CREDIT              RMA #:                Mississauga, Ontario, L5C 1T7                                           Phone:(905) 804-9488         Fax(905) 804-9507                                 DOA             EXCHAGE   COMPANY NAME:__________________________                                         PHONE:                            COMPANY ADDRESS:                                                                  FAX:                                  REQUEST DATE:                                                              CONTACT PERSON:                          NOTICE:  THE INFORMATION CONTAINED THIS FORM AS BELOWS WILL NOT BE ACCEPTED UNTILL THEY ARE CONFIRMED WITH RMA DEPARTMENT. ALL RIGHTS RESERVED. THANK YOU.      PART #   INVOICE# INVOICE DATE    QTY                 S/N    Problem Description R      RMA DEPARTMENT USE ONLY                                                                                                                                             REMEMBER §         RMA only process when the above information fully provided. §         All fixed or replaced RMA products will be shipped to you together with your next purchasing order.   Received By:                                                                Customer received Sign:                   Warehouse Sign:                                                           Date Received:

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