*Reporting Dealer / SC:

*Name:

*Dealer Shipping Address:

*Email Address:

*Phone:

*Avidyne RMA Request Type:

*Dealer PO #:

*Date unit needed:

Previous Avidyne RMA #:
(If applicable)

Original Equipment Information

*Equipment Type:

Warranty Status:

*Hardware Part #:

*Software Part #:

IFD Software Part #:
(Required for R9 RMAs)

*Unit Serial #:

Datalink Type:

CMax:

TAWS:

Traffic Type:

Nav Database:

Flight Director:

Bezel Color:

Radar Type:

*Reason for Service:

Shipping Account Information

Avidyne does not cover shipping, customs, or duty fees for international customers.

Shipping Company:

Shipping Account:

Shipping Method:

Fault and Flight Condition Information

Flight Operations:

Flight Condition:

During Calibration
(PFD/IFD Only)

Was any other equipment removed at the same time?

Please List:

Aircraft/Customer Information

*A/C Make:

*A/C Model:

*A/C Tail #:

*A/C Serial #:

*Customer Name:

*Customer Phone:

*Customer Email:

Fax Number:

Street Address:

City:

State/Country:

Zip Code: