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Returned Material Authorization (RMA) On-Line Request Form

Prior to returning any products to Divebiss for repair, each product must be issued a Returned Material Authorization (RMA) number. To request an RMA, you must either download and complete the RMA request form or complete this on-line form to receive your RMA number.

Please complete the following form to request a Returned Material Authorization (RMA) number to return a product for repair.

Company & Contact Information
Company Name:    
Phone #:    
Fax #:    
Technical Contact: E-mail:
Purchasing Contact: E-mail:
Purchasing Information
If you have open credit, please provide Purchase Order number. Otherwise, you will need to provide a billing method when you are given the RMA number. We accept VISA Mastercard and American Express. COD or pre-payment may also be used.
Purchase Order #:    
Bill to Address
Street:
City:
State:
Zipcode:
Ship to Address
Street:
City:
State:
Zipcode:
Product Information
Model #:
Serial Number:
Description of Problem:
Additional Comments
 
  By submitting this form, I agree I have read and understand the Divelbiss RMA Policy and agree to it's conditions. I hereby state that I have the authority and do authorize Divelbiss Corporation to bill the provided method for the product repair upon repair completion.