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Return Materials Failure Report

Please fill out this form completely and attach to your Return Materials Notice.

Re: RMA #: _________________________

Please describe the mode of failure for each item being returned:

Item	Serial Number	Description of Problem
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________
_________	____________	___________________________________________

Any questions regarding this form or the return of materials to Tomtec should be addressed to the Service Department at (203) 281-6790.
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