MHL Computer Products - The One for Quality Bank and Credit Union Printers... You Can Bank On It

PRINTER/SCANNER REPAIR SUBMISSION FORM
Please enter all information accurately, incorrectly entered information will cause delays in the processing of your repair request.

Enter your company and contact information in the spaces below: ( * denotes required field)

*Company Name:

*New Customer?

Yes No New customers, please select "yes"

*Contact Name:

Contact Phone:

*Contact E-Mail:

Please select the type of contract/payment agreement you have with us. If you are a new customer select the "Time & Materials" option and enter an authorized repair dollar amount.

Warranty		If warranty please enter the purchase date.
Maintenance Contract
Flat Rate Contract
Time & Materials	$	Please enter an authorized repair dollar amount.

Click the button below to create a unique return authorization number:

Record this number for your own records and on the shipping label of the returned printer/scanner.

Enter information for the printer/scanner that is being repaired in the spaces below. If multiple printers/scanners are being submitted please separate with a comma:

*Manufacturer & Model

*Serial Number:

*Problem Description

Ship all defective printers/scanners to the address below. Make certain to include the RMA number from above on the shipping label:

Ship defective printers/scanners to:

MHL Computer Products Inc.
ATTN: Returns Dept. RMA#
422 W. Dussel Drive
Maumee, OH 43537

Enter the address you would like the printer/scanner returned to after it has been repaired:

*Ship repaired printers/scanners to:

ATTN:

Do you require MHL to send you a shipping container? Yes No ($15.00 per container)

Acknowledge your acceptance of the Terms & Conditions of this agreement.

*I have read and accept the Terms & Conditions (you must check this box to continue)

** Please print a copy of the form for your own records before sending. Sending the form may take a few moments, you will receive a confimation notice on the screen when the form is successfully submitted **

If you have any questions or problems submitting this form please call MHLCP Customer Service at
1-866-MHL-4FIX (1-866-645-4349)