Samsung Return Form Please enable JavaScript in your browser to complete this form.Application for Defectives/Concealed Damage RMAThese are the following Samsung Requirements. Please go over these requirements and make sure that everything on this checklist is met before you submit your request. Failure to meet all of these Samsung requirements will result in your request being denied. If your unit is DOA or Defective please call Samsung Dealer hotline first (866) 797-8727 If an RMA is approved, the authorization number and return instructions will be e-mailed to the provided contact. If the unit is defective no pictures are required. All units sent in for replacement must have original box that the unit came in.Your Retail Company Name: *Davis Distribution Customer Number:Dealer Phone: *Email: *Reference Code If Provided: *Date of Installation:Is the unit damaged or defective? *DamagedDefectiveCurrent Location of Damaged UnitsLocation Name:AddressAddress Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeContact Name: *FirstLastLocation where damage was discovered:DistributionRetail LocationEnd-UserFirst Item *Add ItemModel:Serial Number:Description:Delivery Date:Second ItemAdd ItemModel:Serial Number:Description:Delivery Date:Third ItemAdd ItemModel:Serial Number:Description:Delivery Date:Fourth ItemAdd ItemModel:Serial Number:Description:Delivery Date:Fifth ItemAdd ItemModel:Serial Number:Description:Delivery Date:Required Sales Receipt for Concealed DamagePhoto 1 Click or drag a file to this area to upload. Sales receipt for concealed damagePhoto 2 Click or drag a file to this area to upload. Serial tag on unit - number must be readablePhoto 3 Click or drag a file to this area to upload. Serial tag on box- number must be readablePhoto 4 Click or drag a file to this area to upload. Full front view of shipping/unit box with all 4 Corners IncludedPhoto 5 Click or drag a file to this area to upload. Full back view of shipping/unit box with all 4 Corners IncludedPhoto 6 Click or drag a file to this area to upload. Full left view of shipping/unit boxPhoto 7 Click or drag a file to this area to upload. Full right view of shipping/unit boxPhoto 8 Click or drag a file to this area to upload. Clear photo of unit damage, including surrounding, TV Must Be On Photo 9 Click or drag a file to this area to upload. Full Picture Of TV On Must Include All 4 CornersAdditional Comments:Submit
