Kele Industrial Automation
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Events
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Personal Information
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Company Information
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References
First Name
*
Last Name
*
AP Email Contact
*
Email for Invoices
*
Title
*
Phone number
*
Name of business
*
Tax ID
*
Hidden
Address
Shipping Address
*
City
*
State
*
Zip
*
Billing Address
*
City
*
State
*
Zip
*
A-tech Sales Rep Name
*
Year founded
*
Legal form in which business operates
*
Corporation
Partnership
Proprietorship
Is your company tax-exempt?
Tax exempt number
*
Tax exempt electronic pdf
*
Max. file size: 50 MB.
If division or subsidiary
Parent company
Year founded
First name of person authorized for business transaction
*
Last name
*
Title
*
Phone number
*
Address
*
City
*
State
*
Zip
*
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Manually enter reference information
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Max. file size: 50 MB.
Company name
*
Contact name
*
Phone number
*
Address
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City
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State
*
Zip
*
Company name
Contact name
Phone number
Address
City
State
Zip
Company name
Contact name
Phone number
Address
City
State
Zip
CAPTCHA
1
Company Information
2
Product Information
3
RMA Detail
First Name
*
Last Name
*
Name of business
*
Email
*
Phone number
*
Part #
*
Quantity
*
Part #
Quantity
Part #
Quantity
Original PO #
Date Code
If repair is not feasible or credit cannot be give
*
Scrap at Factory
Ship back to customer
Return Type
*
Repair
Replace
Return for Credit
Reason for Return
*
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.
Forms
Fill out credit application
Fill out RMA Form
Download W-9 form
Download line card
Download terms and conditions
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Kele Industrial Automation
Kele Industrial Automation
