RMA No. Request
Contact Data
Salutation
Mrs.
Mr.
Name
*
Company
*
Postal Code
*
City
*
Street
*
Phone
*
Fax
*
e-Mail
*
Products
Device #1
Product
*
Serial no.
*
Problem Description
*
Occurence
*
At first power on
During operation
<<< More Numbers >>>
<<< Less Numbers >>>
Miscellaneous comments:
*
I accept the "Privacy Policy" and the "Warranty and Repair Conditions" of LiPPERT Embedded Computers GmbH
We use your personal data indicated above only to answer your inquiries, to execute agreements concluded with you and for technical administration, filing and invoicing. Your data will only be disclosed to third persons, if this is necessary for the purpose of contract execution or for invoicing or if you have given your consent before. You have the right to revoke your consent at any time with future effect. See our
privacy state
for details about the use and protection of your data. Here you will find our
Warranty and Repair Conditions
.
print form
* required
LiPPERT Embedded Computers GmbH, Hans-Thoma-Str. 11, D-68163 Mannheim, Phone +49 (0) 621 / 43214 0, Fax +49 (0) 621 / 43214 30, info (at) lippertembedded.com