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Returned materials authorization request form


DICG is dedicated to providing Customer Service and Support that exceeds expectations.  We want to help efficiently and quickly address your Veeder-Root product repair. Rest assured that a DICG Sales Support Representative will respond to your RMA inquiry promptly - usually within one business day.

There are two methods of processing an RMA inquiry:
1) Download and print our RMA request form, enter required information, and FAX it to Customer Service at +1.910.879.5486. 
           Get RMA form here:  RMA Form

2) On line RMA request using the following form.  When completing the RMA form below, please be as specific about your problem as possible and include Product, Model Number, Serial #, and Purchase Order #, as well as any pertinent Application details. The more information you give us, the more quickly and more thoroughly we can solve your problem.

We guarantee to respect your privacy and to never release your personal information to a third party. Please read our Privacy Policyfor further information on this policy. We look forward to serving you!

* All starred fields are required.

Return Request Information

Model # Quantity Serial # Purchase Order #
 
Please provide "Ship To" Address information if different from Contact info:
Please indicate the
industries your company does business with:
* Please provide a detailed description of the problem you are having:
Are there any additional application details that may assist us with your repair:
How did you learn
about our website:

Contact Information

* First Name: Title:
* Last Name: * Company:
* Street Address: Company Website:
* Email:
* Phone Number:
Fax Number:
* City: * How would you classify your business?
* State/Province:
* Zip Code: How would you
like to be contacted?
Phone Email Fax
* Country:
 
Would you like to receive special offers & notification of new product releases via email?    Yes    No
 
  
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