RMA Request
(Returned Material Authorization)

Required fields are indicated with an asterisk (*) and must be completed before your request can be accepted (you may either complete "Invoice Number" or "Sales Order Number;" both are not required). Requests will be reviewed by your rep. When approved, an RMA number will be sent to you. International customers please use "Non-USA" for your rep's name.

* Who's your Milbank Rep? 
* Customer: Milbank Account Number:
* Contact: Ref / D.M. Number:
* Address:
* City:    * State:   * ZIP:
* Phone:    * FAX:   E-mail:

Return Quantity* Catalog Number* Unit Cost/Price* Invoice Number* Sales Order Number* Return Reason*
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