Emergency Lighting, Warning Lights, And Other Emergency Equipment

Request for Code 3 or PSE Amber™ Return Authorization Number
(Repairs ONLY Please! Absolutely No Items for Credit via this Form)
* Denotes required fields.

To request a return authorization number, for repairs ONLY, please complete the following form. Mandatory fields are indicated by an asterisk (*), and MUST be completed before submission in order to receive a Return Authorization Number. Of course, you may contact the factory Technical Service Department directly by telephone at: (314) 426-2700 for a Return Authorization Number, if you prefer.

*Your Company Name:

Your
Account Number (if known):

*Your Name:

*UPS Deliverable
Street Address:

*City:

*State :

*Zip:

Country:

*Phone No.:

Ext:

Fax No.:

*E-Mail Address:

Your Tracking,
Reference, or PO Number:

Please list the item(s) you wish to return for repair or modification:

	Product	Serial/Date	Qty	Describe Problem (If Known)
Item 1
Item 2
Item 3

Your Questions or Comments
Referencing this Repair :

I will Ship to you via:

Please Notify Me of the
Authorization Number By:

Submission of this form does NOT constitute a contract by PSE/Code 3 in any manner, unless and/or until a response has been issued by the Service Department. All Authorization(s) are subject to the approval of a Code 3 authorized representative. For additional details, or if you have additional questions, please contact the factory directly. (Please allow three business days for processing your submission before a response is issued by a Code 3 Representative).


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