Securiton GmbH
Von-Drais-Str. 33	Securiton GmbH
77855 Achern	Tel.:	+49 7841 6223 57
Germany	Fax :	+49 7841 6223 131
reparaturen@securiton.de
RMA-No:
* available from Securiton

Company:	Customer No.:
Address:	Invoice No.:
Town/Postcode:	Delivery note No.:
Contact:	Telephone No.:
Email:	Fax No.:

Quantity	Item number.	Item description	Serial number	Detailed fault description

Replacement in advance	Estimate	Processing / Repair – Repair / Exchange (only for office use of Securiton GmbH)
Yes	No	Yes	No	Repair	New Part	Warranty

Description/Note

I hereby confirm that the provided device has been properly sterilized, (see accompanying leaflet „surface disinfection swiping procedure“) and therefore there is no risk of infection for the device recipient.

a. Items arriving without sufficient postage, without a fault description will be returned to the sender unprocessed. The sender will be liable for any postage to be paid. b. Please attach the RMA number and ensure it is clearly visible on the cover of your return. c. Please return only a fully completed form. d. In case of no faults being identified, test costs incurred plus post, packaging and VAT will be invoiced.	e. The general terms and conditions of Securiton GmbH are valid. f. There will be a fixed cleaning rate of 25 € for each device/appliance that has not been sterilized.	Indications:

Certificate enclosed: yes no

Date:

Sender:

Processing

Please fill in the complete form. It is imperative that you make a comprehensive and detailed description to ensure swift processing.

Once completed the form it is to be sent to the appropriate repair centre.

You will receive the required RMA number promptly, and if applicable an estimate, or we will contact you to discuss details or queries.

The following guidelines are to be observed when shipping items to the appropriate repair centre:

Returns have to be made in original packaging wherever possible or in packaging of equivalent quality.

Additional packaging is strictly required to avoid damage in transit.

Please enclose a copy of the RMA form.

All consignments have to be made “free domicile”. Items arriving without sufficient postage, without a fault description and will be returned to the sender unprocessed. The sender will be liable for any postage to be paid.

Please note that we are unable to accept returns without a RMA number.

Should any returned items turn out not to be faulty, you will be required to pay an assessment charge and any subsequent postage to return the item to you.