RMA Request (Return Merchandise Authorization)

This form allows users to submit a Returned Material (RMA) request. This does not ensure that the RMA request will be approved. By completing this form, an RMA number will be generated for tracking purposes.

The items marked by an asterisk are mandatory fields and must be completed before submitting the form.

Contact Information

First Name *

Last Name *

Job Title *

Company Name *

Email Address *

Address Line 1

Address Line 2

City *

State/Province

Country *

Postal Code

Telephone *

Product Information

Adesto Part Number *

SL Number

Customer Part Number

Invoice Number *

Invoice Date *

Sales Order Number *

FA Number

Price (Each) *

Quantity (to Return) *

Returned for *

Other Contact Info

End Customer

Distributor/Sales Rep

Distributor/Sales Rep (Contact)

Distributor/Sales Rep Email

Distributor/Sales Rep Phone

Reason for Return (please include detailed explanation)

Comments *

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RMA Request (Return Merchandise Authorization)

Contact Information

Product Information

Other Contact Info

Reason for Return (please include detailed explanation)

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