Please complete all of the fields on the form and click submit. Within 24 hours or the next business day, a Customer Service Representative will process your information and e-mail you a Return Authorization number (RA^#).

* Please Note: An RA^# number must be clearly marked on your return shipment label so that it can be processed and tracked properly

Organization*
Organization Name*:
*the organization name owning the equipment is required in order to process this return
Service Center Name (if returning for an organization):
Contact Name*:
Phone Number*:
Fax Number:
E-mail Address*:
Ship to*:
Organization Name*: Attention to Name*: Street Address*: Cty*: State*: Zip*:
Bill to (if different than Ship to):
Organization Name: Attention to Name: Street Address: City: State: Zip:
Product Information:
System Serial Number*:
Part Serial Number: (if different from System Serial Number)
Please Note: if you are returning a part with no serial number, please indicate the serial number of the system/unit it is a part of
In warranty?
Yes  No  Not Sure, please check account status
Item(s) being returned*:
Please take exceptional care in packing any equipment for return to avoid possible damage during shipping. L-3 Mobile-Vision cannot accept responsibility for Items received damaged in shipment.
Return Reason*:
	Repair Advance Replacement** Incorrect Part Received or Ordered Other
Comments/Explanation of Above Reason:
*This field is required to process this request, you must fill this in. **Advance Replacement applies only if a unit is received “bad out of box” or within 30 days of installation (proof of installation date and serial number required)