Polycom RMA Request form

Polycom RMA Declaration:

If the item for return is covered on iCare warranty, please contact our iCare support line on 01635 294323 with the full main unit serial number and iCare warranty number.

Chargable out of warranty repairs can only be placed by resellers with a valid purchase order, if the item requested for RMA is out of warranty then we will contact you to inform of repair costs.

Please ensure that when returning your faulty Polycom equipment, all accessories and modules are retained by you. This includes:

• Cables
• Remote control
• microphone
• ISDN module (QBRI) if fitted to the item being returned

If the camera and codec are separate units (e.g. VSX8000) return only the faulty part, either camera or codec, not both. Polycom are unable to return items sent by mistake.

Please also identify any software options that may be loaded onto any returned codec. (multi-point software, Content software that might have been modified.

Equipment Test List	Please choose
The item being reported has been tested with known working unit / peripherals and as such can be confirmed as faulty.	Yes No
The item being reported as faulty is the base unit of equipment.	Yes No
The item being reported is the power supply of equipment.	Yes No
The item being reported as faulty is a peripheral of main equipment.	Yes No

RMA Requested by (Reseller):

Contact Name

* required

Job Title

Company Name

Telephone

* required

Fax

E-mail Address

* required

Ship-to-Address for replacement

Contact Name	*required
Contact Tel. No	*required
Company Name	*required
Address Line 1	*required
Address Line 2
Town/City	*required
County
Post Code	*required

Select Partner Programme

Please Select Below Partner Premier Partner Premier Plus Service Reseller

In Warranty Service	Out of Warranty Service
Emergency Exchange Standard Repair / Return DOA	Emergency Exchange 10 Day Standard Repair / Return 30 Day Standard Repair / Return

Equipment Information:	Unit Information
Model Name	*required
Serial Number	max 14 digits
Date of Purchase (day, month,yr)	Day: Month: 1 2 3 4 5 6 7 8 9 10 11 12 Year: 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1989 1988
Failure Description