QIII RMA Request

Please fill out the required information.
If you need any assistance or would like any additional information, please email PSGcustomerservice@pen-tec.com

CONTACT INFORMATION

First Name*

Last Name*

Company*

Phone*

Email*

RETURN SHIPPING INFORMATION

Address*

City*

State*

Zip Code*

Country*

QIII UNIT INFORMATION

Serial Number*

8 or 10 digit number located on the back of your unit.

QIII Model*

Reason for Return*

Acknowledgement of Obligation and Decontamination Certification

By accepting authorization to return this product to Pentagon Technologies, the customer/user hereby assumes all responsibility and liability for, and holds harmless and releases Pentagon Technologies from liability for; biological, chemical and radiological decontamination and cleaning of the product(s) and/or packaging associated therewith.

Hazardous Materials and/or Environment*

Check this box if the product subject to the Return Authorization WAS NOT subjected to hazardous materials and/or environment.
Check this box if the product subject to the Return Authorization WAS subjected to biological, chemical, radiological, or other hazardous material and/or environment and has been appropriately decontaminated, and the decontamination has rendered the product safe for handling. If this box is checked, please fill in known contaminate(s) and Cleaning Agent(s) used.

Known Contaminant(s)

Cleaning Agent(s) Used

Repair Details

A - Unit doesn't boot up
B - System won't zero count
C - System won't count
D - Touchscreen doesn't work
E - Probe doesn't work
F - Other

Additional Information

Optionally, Upload a Photo of the Issue Here

Accepted file types: jpg, gif, png, jpeg, Max. file size: 2 MB.

Verification Code

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Name

This field is for validation purposes and should be left unchanged.