In Warranty Distributor Sales Partner

Personal Information

First Name: *

Last Name: *

Phone Number: *

Email: *

Requested Return Address ❔

Line 1: *

City: *

State: *

ZIP Code: *

All REPAIR or REPLACEMENT items will be delivered to the return address provided by the customer above.

Purchase Information

Date Purchased: *

Model Number: *

Serial/Lot Number:

Summary of Issue: *

CPS Sales Order/
Invoice Number:

PO Number Used to
Purchase From CPS:

Requested Action

Attach Proof of Sale/
Proof of Purchase:

CPS will evaluate the request and decide on an action as appropriate.
All Items Returned Must Include a Return Authorization attached.
All Items Returned Must be shipped to: 1010 E 31 St, Hialeah, Fl 33013, USA

Describe Failure Describe Failure:
(optional) Please be advised that your RA request may be forwarded to a technician for troubleshooting depending on the product and nature of the claim. Please provide the best time to call. Thank you!

In Warranty Distributor Sales Partner

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