Fill out and include this document in the return shipment!	RMA / Ticket No.
No Returns without Support ticket and Return Form - available at – www.sotax.com/services and support

Basic Information
* Date:
* Company Name:
* Address:
* City / State / Postal code:
* Contact person & phone no.:
* E-Mail
* Unit / model type / part no.:	* Article no.:
Order or delivery note no.:	* Qty.:	* Serial no.:

* Reason for Return with Description
☐	For repair (no cost estimate)	☐	Warranty claim	☐	For credit note
☐	For repair (with cost estimate)	☐	Return after service contract replacement (-A) (not defect)
☐	Back from SOTAX service technician stock	☐	other
*

* Instructions for Return Shipping
Return shipping company (i.e. UPS, FedEx, etc.):
Provide account # for collect shipping:
Insurance required? Yes/No If yes, amount of insurance?:
Other:

* Safe Handling of Material being returned
No	Yes	* Has this unit / part been used for work with substances from which a risk can emanate?	If yes, specify substances and add all relevant MSDS sheets.
☐	☐
☐	☐	* Has this unit / part been decontaminated or disinfected?	Material contaminated with microbial, explosive, radioactive of toxic substances are only accepted it proof of proper cleaning is presented!
☐	☐	* Is the material still risky even though it has been decontaminated or disinfected?	If yes, which protective measures are necessary for the repair / maintenance?
Even Sotax will always take best efforts it cannot be fully guaranteed that customer specific data (such as methods or local settings) may get lost during the repair process. We strongly recommend a full data backup prior returning any equipment for repair.
The undersigned assures on behalf of the legal entity (company) that the information given above is true and complete and that a proper decontamination of the unit / model / parts has been carried out by expert personnel. It is known to the client that he can be made liable to the contractor for damages in the event of breaches, here in particular in the event of health impairments to the personnel of SOTAX.
* Date:	* Signature:

* Required Fields

Address Information

Europe, Middle East & Africa
Switzerland & all not specific mentioned countries	SOTAX AG Nordring 1 CH-4147 Aesch
Germany	WeDeclare GmbH z.v. SOTAX Gewerbestrasse 17 DE-79618 Rheinfelden-Herten
France	Transport Woehl C/O Sotax Sarl 11 rue de Bayonne 67100 Strasbourg
Italy	SOTAX AG Nordring 1 CH-4147 Aesch
United Kingdom	SOTAX Limited Rutherford House, Tomlinson Business Park Woodyard Lane | Derby DE65 5BU | United Kingdom Phone +44 1332 981304

North- & South America
USA & the not specific mentioned country	SOTAX Corporation 2400 Computer Drive Westborough, MA 01581
Canada	SOTAX (Canada) Ltd. 1-335 Deerhurst Drive Brampton, ON L6T 5K3

Asia-Pacific
India	SOTAX India (Pvt) Limited Anupam Annapolis Office no:2,3 & 4, 3rd Floor CTS no:48, Aarey road Goregoan East Mumbai 400063 India

For all other countries visit our SOTAX Homepage: www.sotax.com