FLIR Systems

Return Material Authorization Request

Copyright Thank you for choosing FLIR Dubai Service Center to support your instrument. To allow
our Service Support Team to respond more efficiently to your request, we kindly ask you to
© 2018, FLIR Systems, Inc.
complete this form by providing the requested information. Return this form to the FLIR
All rights reserved worldwide. Names and Dubai Service Center at Fuad.Halalsheh@FLIR.com and/or Service.Dubai@FLIR.com.
marks appearing herein are either registered
trademarks or trademarks of FLIR Systems
and/or its subsidiaries. All other trademarks,
trade names or company names referenced • Please do not return any material before receiving an RMA number from
herein are used for identification only and are the Service Department.
the property of their respective owners.
• Clearly mark the RMA number on all shipping documents and on the package.
Document identity Failure to do so will delay customs import clearance. Due to new IATA air
Publ. No.: T810211
freight rules, do not return batteries with the camera. Doing so will delay
Release: G
Language: en-US the return of your equipment.
Modified: 2019-01-07 • An investigation charge of $200 for low-end handheld cameras and $300 for
Website cooled science cameras will be invoiced if our quotation is not approved.
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Customer support Distributor/customer

http://support.flir.com
Invoice address
Disclaimer
VAT/Org. number Web Address
Specifications subject to change without
further notice. Models and accessories Contact person P.O. No./Ref. no.
subject to regional market considerations. Telephone E-mail address
License procedures may apply. Products
described herein may be subject to US Shipping address
Export Regulations. Please refer to
exportquestions@flir.com with any
questions.
Contact person
Telephone E-mail address
Quotation Yes No Only if the cost exceeds
Type of instrument
Serial number License number
Enclosed
accessories

Reason for return

(detailed description of the
problem)

Warranty Yes No

General maintenance including calibration

Accuracy control report requested (at extra charge)
Declared customs value

Copyright
© 2018, FLIR Systems, Inc.
All rights reserved worldwide. Names and
marks appearing herein are either registered
trademarks or trademarks of FLIR Systems
and/or its subsidiaries. All other trademarks,
trade names or company names referenced
herein are used for identification only and are
the property of their respective owners.
Document identity
Publ. No.: T810211
Release: G
Language: en-US
Modified: 2019-01-07
Website
http://www.flir.com
Customer support
http://support.flir.com
Disclaimer
Specifications subject to change without
further notice. Models and accessories
subject to regional market considerations.
License procedures may apply. Products
described herein may be subject to US
Export Regulations. Please refer to
exportquestions@flir.com with any
questions.
FLIR Systems
Return Material Authorization Request
Delivery conditions: Ex Works Dubai (Incoterms 2018)
Please state if you have an account with a preferable forwarder/courier, otherwise we will ship
on our account and add the freight charge to the invoice – CPT xxxx, except when warranty.
Military End User? Yes No
(national armed services, including army, navy, marine, air force, coast guard; national guard;
national police; government intelligence or reconnaissance organizations; or any person or
entity whose actions or functions are intended to support military end-uses)
Incorporated into a Military Commodity? Yes No
Military End Use? Yes No
(meaning incorporation into a military item described on the U.S. Munitions List or on the
Wassenaar Arrangement Munitions List; or to commodities classified under any U.S.
Commerce Control List “600” series ECCN, ECCN ending in “A018,” or ECCN “0A919;” or for
the use, deployment or production of military commodities (regardless of country of origin) that
are described on the U.S. Munitions List or the Wassenaar Arrangement Munitions List, or that
are classified under any U.S. Commerce Control List “600” series ECCN, or ECCN ending in
“A018,” or ECCN “0A919.”).
9Hz Declaration: I/We, hereby acknowledge that the above mentioned FLIR products are
classified under Export Control Classification Number (“ECCN”) 6A993.a for U.S. export
control purposes and may not be exported, re-exported, or transferred to a “Military End-User”
or for “Military End-Use” in any country except the U.S. or Canada, except as approved under
a U.S. export or re-export license.
End user
(full name and contact details,
including physical address)
Intended End Use
(please provide a detailed
explanation of the intended
usage of the unit)
Additional data
(please add any additional
information that might be
pertinent to your request)
Date
Name in block letters
Title
Signature