Returned Product Form for Coupled-Cavity Traveling-Wave Tubes Quality System Documentation Proper Completion of This Form is Vitally Important to the Prompt and Efficient Handling of Product Warranty Claims. I. This claim form, properly completed, must accompany any returned Product and be received by CPI Microwave Power Products (MPP) prior to expiration of the adjustment period. Compliance with this requirement assures the user of the most prompt and thorough service possible. A Product returned within the adjustment period, but without the completed Returned Product Form, will be treated as out of warranty. II. Complete the following information regarding the Product being returned: A. Returned Material Authorization No.: (Call CPI/MPP Customer Service Department to obtain this number.) B. Product Type: CPI Part No.: Serial No.: Customer Part No.: C. Customer Purchase Order No.: Date of Purchase Order: D. Control Specification No.: (Check one) E. Dated: Document of CPI Document of your company Contract Warranty (either CPI Warranty Code or specification paragraph): Filament Hours: Adjustment Time: Warranty Adjustment Began: (months) Expires: III. Claim is made against warranty based on the following: A. Specifications(s) not met by the Product (list by specification and paragraph number): Updated Pub. 5447 to QSD format Verify revision before use. MK 4023-3004 Rev. – ECO: MPP615204 Date: 2/1/16 Page 1 of 3 Returned Product Form for Coupled-Cavity Traveling-Wave Tubes Quality System Documentation PLEASE FILL IN FOR FAILED PRODUCTS: (Place an “X” in the appropriate box to show what variance from normal was seen at the time of product failure.) *Product S/N Product Type Date Date Filament Radiate Filament Beam Body High-Voltage W/G Coolant Mechanical Installed Failed Hours Hours Current Current Current Arcs Arcs Flow Problems Lo Hi Lo Hi Nml Hi No Yes No Yes Nml Lo No Yes ElectroMagnet Current Nml Lo *It is necessary to have the Product serial number rather than the system serial number. B. Describe the circumstances and/or sequence of events under which the Product failed. Include remarks relating to installation problems, system anomalies, and so forth. IV. System used in Serial No.: V. Purchaser’s Name: Address: Telephone: Claim made by: Name of person to contact for additional information: Telephone: (Signature) (Date) MK 4023-3004 Rev. – ECO: MPP615204 Date: 2/1/16 Page 2 of 3 Returned Product Form for Coupled-Cavity Traveling-Wave Tubes Quality System Documentation Return completed form with Product promptly to Communications & Power Industries LLC Microwave Power Products Division Building 2 Receiving 811 Hansen Way Palo Alto, CA 94303-0750 Attention: Returned Products/RMA #____________ Tel: Fax: E-mail: (650) 846-3900 (ask for MPP Customer Service Department) (650) 856-0705 [email protected] CAUTION DAMAGE CAN OCCUR IF COOLANT IS NOT REMOVED BEFORE PRODUCT SHIPMENT. MK 4023-3004 Rev. – ECO: MPP615204 Date: 2/1/16 Page 3 of 3