REPAIR AND RETURN FORM

Updated 10/14/2004

INSTRUCTIONS:

  1. Use this form when shipping RAWS equipment to the BLM Depot for repair and return.
  2. Using this form is for the special exception when parts cannot be ordered through the Depot (example: Depot does not have this part in stores).
  3. One copy of this form should be included with EACH package shipped.
  4. Please be sure to keep records of UPS or FedEx tracking numbers of your packages until you are sure the Depot has received them.
  5. Using this method could cause the user to incur additional costs if used incorrectly.

Date:               /            /              

Contact Information:

NAME:                                                                                                                                                           

PHONE:  (              )                                   EMAIL:                                                                                      

AGENCY/REGION:                                                                                                                                     

UNIT:                                                                               SUB UNIT:                                                                        

Station Information:

STATION NAME:                                                                                                                 

FEDERAL JOB CODE:                                                   OVERRIDE:                                             

Contents Description:Serial Number:
                                                                                                                                                                               
                                                                                                                                                                               
                                                                                                                                                                               
                                                                                                                                                                               
                                                                                                                                                                               
                                                                                                                                                                               
Other Information/Notes:                                                                                                                   

                                                                                                                                                                                       

                                                                                                                                                                                       

SHIP TO: RSFWSU BLM/NIFC - 3833 S. Development Avenue - Boise, ID 83705