Actual Customer / End User Information

Purchase Date (mm/dd/yyyy)
Your Invoice #

Company Name:

Contact Information
First Name
Last Name
Phone ext.
Fax
Address
City State Zip Code
Email Address
Submit E-mail Address for Immediate Confirmation


WHERE DID YOU BUY IT? (Dealer Information)
Skip This Section if Same as Above

Purchase Date (mm/DD/yyyy)
Albatron / Monivision Invoice #

Company Name:

Contact Information
First Name
Last Name
Phone ext.
Fax
Address
City State Zip Code
Email Address
Submit E-mail Address for Immediate Confirmation


Other Information

Did you try all of the steps listed on our troubleshooting guide? YES NO
If NO, please visit the troubleshooting guide before going any further:
Simple Troubleshooting Guide (PDF)

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Problems and Symptoms



Working Environment
Desktop PC Notebook PC Notebook MAC MAC


Horizontal Frequency
640x480 800x600 1024 x768 Other
If "Other," please explain

Vertical Refresh Rate
60 Hz 72 Hz 75Hz 78Hz 80Hz 82 Hz 85 Hz+ Others
If "Other," please explain


Location of Monitor
Office Classroom Outdoor Others
If "Other," please explain


Product Model



Serial Number(s)




I agree to deduct 15% restocking fee from the credit to the original purchase price.
(Return is acceptable only if it is within the 14 day-period from the original date of purchase. Monivision is not responsible for any shipping damages)


If you have any questions with regard to this fee,
please contact Monivision Service at service@monivision.com

Signature
Type in Your Full Name to Digitally Sign the Form.

Date (mm/dd/yyyy)

**(1) Some remote area, on-site may not be available (2) Outside the on-site service area, may be either prepaid freight back to Monivision service center or obtain at extra charge.

Thank you for submitting your RMA form. After reviewing your information, you will be contacted and given an RMA number. Only at that time may you return the product to Albatron/Monivision USA. Should you have any questions during this process, please contact us at service@monivision.com