Request for Return Authorization

All items returned to Geokon, Inc. must have an officially issued Return Authorization (RA) Number, which can only be acquired by contacting Geokon, Inc. directly. Geokon will NOT accept, nor work on, any returned items without a Return Authorization Number and a signed Health and Safety Clearance Statement.

Return Authorization Process:

1. Please fill out and submit the form below to initiate a request for Return Authorization (note: items marked * are required). Or, you may contact the Geokon, Inc. Repair Department via the contact information found below.

2. Geokon, Inc. will assign a Return Authorization Number, then contact you directly to provide this number along with the Return Authorization Form.

3. The Return Authorization Form contains a Health and Safety Clearance Statement which must be signed and returned to Geokon, Inc. Please submit the completed form via fax: 1 (603) 448-3216, or email: .

4. The shipping package, containing the returned product(s), must have the assigned Return Authorization Number clearly printed on the outside and the signed Return Authorization/Health and Safety Clearance Statement form included inside.

General Contact Information:

(Date of request: May 17, 2012)

*Company:

*Name:

*Email:

*Phone:

Fax:

Your Billing and Shipping Information:

(Optional) Ship To Different Address:

*Company:

*Name:

*Address:

(Address:)

*City:

*State/Province:

*Zip/Postal:

*Country:

Company:

Name:

Address:

(Address:)

City:

State/Province:

Zip/Postal:

Country:

Item(s) to Return

*Model Number:

*Serial Number:

2. Model Number:

Serial Number:

3. Model Number:

Serial Number:

4. Model Number:

Serial Number:

Reason for Return:

*Please provide a detailed explanation about why you wish to return the item(s) above:

Please Note:

Items above marked * are required.

Returns for CREDIT are subject to restocking fees. Geokon’s inspection for use or damage will determine amount of credit (special circumstances may apply).

Returns for REPAIR or CALIBRATION will receive a Service Estimate once a thorough evaluation has been completed.

Contact Information:

Geokon, Inc. Repair Department

Direct Phone: 1 (603) 448-1562, extension 1307 or 1302

Fax: 1 (603) 448-3216

Email: