Firefly - Return Material Authorization Form

Return Material Authorization Form

* Required information.

For submitting your data don't fill this following email field:

For a faster processing of your returned materials, it is important for us to get as much information about the reason for the return as possible. Fill out this form and send it along with the returned material.

Customer Information

Company: *
Contact person: *
E-mail: *

Address: *
Phone: *
Date *

Item Information

Item description: *
Quantity: *
The part is used in which system (Ex KE01)?
Has the product been exposed to heat, cold water, oil etc? *
Have there been any error messages in the Control unit? If yes, specify. *

Part number:
Serial number:
Problem description: *
Have the problems been intermittent? *

Return Material Authorization Form

Customer Information

￼Item Information

Selection of Customers

Item Information