Haas Factory Outlet - Part Return Authorization Form

Your Company Information
All fields in this form are required!

Date Part Ordered:
/ /

Company Name:

Street Address:

City:

State:

Zip Code:
-

Company Email:

Contact Person:

Phone Number:
--

Ext:

Part Return Information

HAAS Machine Model # Part Was Ordered For:

HAAS Serial # Part Was Ordered For:

Part Number:

Exchange?
50% Exchange
100% Warranty

Why is the Part being returned?
Wrong Part Received
HFO Gave Wrong Part Number
Part was New/Defective