US Technologies - Return Repair Form

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Return Repair Form

For those customers that do not generate purchase orders, this form is to be used when sending in product for repair. All product sent to UST for repair must come back with either the Return Repair Form, UST Quote Form or a customer purchase order.

Please follow these simple steps to complete and then print out the Return Repair Form:

Complete all information indicated as Required
Enter any special instructions or comments in the area indicated on the form
Select type of service (Standard or Rush… more program information)
Enter shipping account information if you have a carrier account number (more program information)
After all is completed, please click on “Format Form” at the bottom of the page. This will bring up a new window with a completed form of your information.
Print this form using the print command on your browser and include this form with your item(s). Be sure to sign the form.

Please make sure the completed signed form is returned with your item(s)

* Required Fields

Bill To:	Ship To:
	(only if different than Bill To)
Contact Name:*	Company Name:
Company Name: *	Address1:
Address1:*	Address2:
Address2:	City:
City:*	State:* Zip Code:*
State: Zip Code:
Telephone: *	P.O. No.:
Fax:	Return Items Via:
Contact Email :	Carrier Shipping Account #:

If paying with Credit Card:
Credit Card Number:	Level of Service:
Name on Card:	Standard
Expiration Date:	Rush

Enter Your Item Information Here:

Qty.*	Part #*	Serial #	Description	Price Ea.*

Additional Comments or Instructions:

Click on below button to submit form when your have finished filling out the
above form. A new window will then appear with a formatted form. You may
then print that window using the Print command on your browser and include
the form with your goods.

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TEL: (800) 234-0862 -or- (201) 475-8700 / FAX: (201) 475-8710
info@ustechnologies.com