Testing RMA Request

* Indicates required questions
Complete all required fields of the form.
Are You a Home Owner or Wholesaler? *
Name *
First Last
Company Name
Address *
City *
State *
Zip/Postal Code *
-
Phone # *
Format: (123) 456-7890
Email *
Please enter your password for your new account:
Password *
Verify Password *
Min 6. Characters
Min 6. Characters

Product Return Information

4-Digit GFI# - (If unknown, you may perform a search on our website.) Only DH Model compressors and evaporator coils use 7-digit numbers. *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
First Item: Comments: *

I am returning a second product Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Second Item: Comments: *

I am returning a third product Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Third Item: Comments: *

I am returning a fourth product Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Fourth Item: Comments: *

I am returning a fifth product Yes No

GFI#: *
Original Receipt / PO #: *
If replacement part has already been ordered, list new Receipt / PO #:
Unit Serial # (Required only for returns of humidifier, HEPA, UV and dehumidifier components)
Installation Date: *
Reason for Return:*
Quantity: *
Fifth Item: Comments: *
VerificationCode
Enter code in image (not case sensitive):