Return Authorization Form | Diaphragm Vacuum Pumps | Sampling Pumps | Compressors

Return Merchandise Authorization Form

Important Return Information

To insure a prompt resolution for the items to be repaired please comply with the following instructions.

Include the fully completed Return Authorization form as well as any supporting documentation with the shipment to:
Air Dimensions Inc
1371 West Newport Center Dr
#101
Deerfield Beach, FL 33442
All Returned shipments Must be shipped Prepaid. ADI will refuse any shipments sent back on a collect basis.
Ship the box prepaid to the address provided above, be sure to include the RA number in the attention line of the shipping label. Please Note our street address has changed from 1015 to 1371.

When your pump(s) arrive at our factory, it will be inspected, we will then attempt to contact you to provide a repair estimate, if applicable. Please note that we will NOT be responsible for pumps left over 30 days beyond this attempt. If you require additional assistance please contact ADI directly at 954-428-7333 or 800-423-6464 (USA and Canada Only).

*By checking this box, I agree to the above instructions.

* - Denotes a required field

Your Corporate Contact Information

Company Name	*
First Name	*
Last Name	*
Telephone	* (include country code if outside US)
Fax	(include country code if outside US)
Email Address	*

Billing/Shipping Information

Bill To
Address Line 1
Address Line 2
City
State/Province
Zip Code
Country

Merchandise Information

Original PO# and/or Sales Order#
Serial#	*
Pump Model#	*
Reason for return	*

Decontamination Declaration

Pump Media Used	*
Please select the statement that best matches the pump you are returning*
This equipment has never been installed in the presence of hazardous materials and is safe to handle. This equipment has been decontaminated and is safe to handle. This equipment has not been decontaminated and is safe to handle without special precautions based on the following:
Please check this box after reading this message*
By checking this box I acknowledge that if the equipment is found to be contaminated regardless of the above statements, it will be returned for decontamination at the customers expense prior to any repair services being performed.

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