Request For RMA Number

Leach International, North America
6900 Orangethorpe Ave.
P.O. Box 5032
Buena Park, CA 90622-5032

Phone: 714-736-7355
FAX: 714-562-8857
e-mail: msc@leachintl.com

Please complete the required information (marked "*") and click Request RMA.

To avoid delays, please provide as much information as possible.

*Your Name:
*Company Name:
*Customer P.O. Number:
*Ship to Address:
*City:
*State/Province:
*Postal/Zip Code:
*Country:
*Phone Number:
e.g. 555-555-5555 x555
Contact Fax:
e.g. 555-555-5555 x555
  Your email address is important. It is used
to communicate your RMA number
  Check to receive email copy of your RMA Request
*Email Address:
*Email Format: Plain text    Formatted text   
Item #
Leach Model
Quantity
Date Code/Serial#
Reason for Return
           

Additional Comments: