Return Request Form

Please enter your contact information below along with information about the products you would like to return under warranty.

Customer Info

First Name

Last Name

Phone Number

Company Name

Street Address

City

Zip/Postal Code

Country

Best Way to Reach You

Optional

If you don't know who your local AtlasIED manufacturer's rep firm is, you can view the territory map HERE.

AtlasIED Account #

Optional

AtlasIED Rep Firm

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Return Information

Receipt Type

Sales Order/Purchase Order/Invoice Number

Date of Purchase

PDF Sales Order/Purchase Order/Invoice Upload

File

Reason for Return/Description of Fault

Additional Notes

Optional