Return Merchandise Authorization (RMA) Request

The following must be completed by Reseller before issuance of a RMA Number.
Product(s) must be returned with complete packaging.

Please place the RMA number on packing slip & shipping label only. Do not write RMA number on original boxes. Use a “shell box” if necessary.

*Required Field

Order Information

Date (mm/dd/year) *

Reseller Company Name *

RMA Reseller Contact *

Contact Phone Number *

Contact E-mail Address *

BlueStar Invoice Number 1 *

BlueStar Invoice Number 2

Invoice Date *

Reseller PO Number

Who is your BlueStar Sales Representative?*

Return Information

Part Number 1 *

Quantity *

Serial Number(s)

Reason (Note If Dead on Arrival (DOA) must state symptom) *

Factory Sealed?

Part Number 2

Quantity

Serial Number(s)

Reason (Note If Dead on Arrival (DOA) must state symptom)

Factory Sealed?

Part Number 3

Quantity

Serial Number(s)

Reason (Note If Dead on Arrival (DOA) must state symptom)

Factory Sealed?

Part Number 4

Quantity

Serial Number(s)

Reason (Note If Dead on Arrival (DOA) must state symptom)

Factory Sealed?

Part Number 5

Quantity

Serial Number(s)

Reason (Note If Dead on Arrival (DOA) must state symptom)

Factory Sealed?

Additional Comments

Dead On Arrival (D.O.A.): BlueStar tech support or manufacturer called to confirm?

Case Number or Tech Support Contact Name

*	I have read and understand the terms and conditions of BlueStar’s RMA policy:

View the RMA Policy

Tech Support: 1-877-478-0013

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