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REPAIR (RMA) REQUEST

ELATION LIGHTING

6122 S. Eastern Ave.

Los Angeles, CA 90040

! THIS INFORMATION IS NECESSARY TO ISSUE AN RMA#

Please E-mail this COMPLETED FORM to rma@elationlighting.com

OR Fax this COMPLETED FORM to: 323.315.7104

CUSTOMER INFORMATION:

DEALER #:

(If Applicable)

COMPANY NAME:

!CONTACT NAME:

!RETURN SHIPPING

INFORMATION:

ADDRESS:

!PHONE #

CITY:

!CONTACT EMAIL:

STATE:

ZIP CODE:

PRODUCT INFORMATION:

!ITEM MODEL #

SERIAL #:

!CORRESPONDING ISSUE(s):

!ITEM MODEL #

SERIAL #:

!CORRESPONDING ISSUE(s):

!ITEM MODEL #

SERIAL #:

!CORRESPONDING ISSUE(s):

!ITEM MODEL #

SERIAL #:

!CORRESPONDING ISSUE(s):