Price Engineering

• Company Name: required
• Applicant First Name: required
• Applicant Last Name: required
• Applicant Email: required

• PO Box/Street Address: required
• Address Line 2:
• City: required
• State: required Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
• ZIP: required

• PO Box/Street Address:
• Address Line 2:
• City:
• State: Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
• ZIP:

1. • Quantity:
   • Manufacturer if known:
   • Model Number if known:
   • Customer P/N:
2. • Quantity:
   • Manufacturer if known:
   • Model Number if known:
   • Customer P/N:
3. • Quantity:
   • Manufacturer if known:
   • Model Number if known:
   • Customer P/N:
4. • Quantity:
   • Manufacturer if known:
   • Model Number if known:
   • Customer P/N:

Please choose a reason and explain in detail.

• Select Reason: customer ordered incorrect material PEC shipped incorrect material supplier shipped incorrect material warranty request non-warranty repair other
• please explain in detail:
• if non-warranty repair, provide a P.O. for charges:

Defective material will be repaired or replaced and returned at no charge, if covered under warranty. Credit will be issued at discretion of manufacturer

A Completed form will be returned to you via email along with an RGA number and shipping instructions.

Do not ship material before receiving an RGA number. The RGA number must be clearly marked on the outside of the return box.