Please enable JavaScript in your browser to complete this form.Customer Name *What date was this part installed? *Name of the part you are returning:Part number of the part you are returning: *Serial number of the part you are returning: *Serial number of the replacement part: *Robot serial number that the part came off of: *Reason for replacement *Cable DamageLeakageIgnores input signalDoes not power upUnreliable output signalFoggingOtherIf other, please explainAre you returning this part to the shop with your name clearly labeled on the part?YesNoIf yes, how are you returning it?Route TruckMailing ItDropped off myself directly to the shopPlease write the number of the carbon copy form (top right of the page) that was given to you when you purchased the part: *Submit
