RMA Form – Blackwire

BlackWire RMA Form

Fill out ALL of the boxes below. Failure to fill out everything will result in a delay of your replacement product being shipped out.

Name

First Last

Email

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Product

Please list the Brand, Model, Serial Number and issue with the product

Order Number*

What is the Blackwire Order number this item was purchased on?

Product Info*

Brand	Model	Serial Number	Reason For Return

NOTE: Click the plus sign on the far right if you need to add more products

Advanced Replacement*

Do you need an advanced replacement?

Credit Card Info

Please provide your credit card information. This is required to send an advance replacement.

Name on card*

C.C. Number*

Card Expiration Month*

Card Expiration Year*

CCV*

3 Digit Security Code from the Back

CCV*

4 Digit Security Code from the Front

Terms & Conditions

Item Condition*

I guarantee that the product I am sending back are not damaged.

Damage Definition:
1. Water Damage
2. Dust Damage (If the product is full of dirt which caused fans to fail and the product to overheat your warranty is most likely void)
3. Lighting / Surge / Voltage Overload

4. Shipping damaged caused by poor packaging
5. Installation damage IE screw marks, scrapes, scruffs, etc

I agree to the item condition terms

Shipping Terms*

I agree to ship the product back with in 5 business days. Failure to ship the product back will result in your credit card being charged for the advance replacement product. If the card provided declines you authorized BlackWire to charge any previously used credit card. If all cards are declined your account will be put on hold and new orders will not be able to be placed until the amount due is paid.

I agree to the shipping terms

As a reminder you can view the terms and conditions you agreed to when placing your order.

https://www.blackwiredesigns.com/terms-conditions/

Signature*

If you are using a mobile phone rotate your phone to fit the signature pad

BlackWire RMA Form

Product

Credit Card Info

Terms & Conditions

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