Parts Return Authorization Company Information* Indicates a required fieldDate Ordered*Company*Street Address*City*State*FloridaZip Code*Contact Name First Last Contact Email* Contact Phone*Part Return InformationModel Number*Serial Number*Part Number*Reason for Return*Select OneWrong part receivedHFO gave wrong part numberPart was new/defectiveExchange?*50% Exchange100% WarrantyNameThis field is for validation purposes and should be left unchanged.