EVModules - Support

Request for EVModules Return Authorization Number

* Denotes required fields

To request a Return Authorization Number, please complete the following form. Mandatory fields are indicated by an asterisk(*),and MUST be completed before submission in order to recive a Return Authorization Number. You may choose contact the factory Service Department directly by emailing direct at services@evmodules.com for a Return Authorization Number, if you prefer.

*Your Company Name:

Your Return Authorization Number(if known):

*Your Name:

*FedEX Deliverable Street Address:

*City:

*State:

* Zip:

Country:

*Phone No.:

Ext.

Fax No.:

*Email Address:

Your Tracking, Reference, or PO Number:

Please list the item(s) you wish to return for repair or modification:

	Product	Serial/Date Code	Qty	Describe Problem(if known)
Item 1
Item 2
Item 3

My Technical Question / Comment Referencing this Repair:

I will Ship to you via:

Please Notify me of the Authorization No. by: