If Shipping from Within the United States Please Use This Label

Return Materials Authorization (RMA) Assigned Customer Service Representative to confirm all information on this form is correct. NOTE: All fields with an asterisk * are required. RMA CASE Kavlico PO for receipt

Customer Part Number *Kavlico Part Number *Serial Number *Quantity

PO Number for Return Is this a new or original? PO (Check one) TBD New PO Original Reason for Return/Rejection Engineering/Qual Unit Where did rejection occur? Receiving Testing End Customer In use

Customer Contact Information *Name *Telephone *E-mail

*Company Name *Ship to Address *Bill to Address

Attention Kavlico Customer: Please note, if RMA Number is not clearly printed on the outside of the box, it will be returned to you at your expense. Please attach the shipping label provided for your convenience. If shipping internationally, please ensure the required US Customs information is included on the commercial invoice, waybill, packing list, and purchase order. HTS for US Goods Returned 2. CLASSIFICATION (USML Category/ECCN) 9801.00.1012 1. HS Code 3. VALUE $ 4. US Export Authorization for RMA (refer to box 2) Attention Kavlico Customer: No license required (EAR99, 9A991) To ensure proper importation, please utilize US Customs Broker listed below. ITAR Exemption (e.g. VIII(h)(1) Place this information on all relevant shipping documents: 126.5(a) for export to Canada c/o Dora Paz Fedex Trade Networks 123.4(a)(1) for any other international export locations 19601 Hamilton Ave. EAR License Exception: RPL ((e.g. 9A610.x) Torrance CA 90502 Phone 310-353-3464 Fax 310-353-3216 If none of the above apply, please contact Trade Compliance E-mail: [email protected] Contact Information for Kavlico CS Representative Additional Contact Info: * For information regarding this return, please contact:(Click Dropdown Menu) Please dial (805) 716-0322, and ask to be or call (Click Dropdown Menu) connected with a Customer Service * Date RMA Approved by CS Representative above. Representative.

AF194 REV. G:08/2015 THESE COMMODITIES, TECHNOLOGY OR SOFTWARE IF EXPORTED FROM THE UNITED STATES MUST BE IN ACCORDANCE WITH THE EXPORT ADMINISTRATION REGULATIONS. DIVERSION CONTRARY TO U.S. LAW IS PROHIBITED. Shipping Labels:

If shipping from within the United States please use this label. RMA NUMBER Kavlico Returns 1461 Lawrence Dr. Thousand Oaks, CA 91320

If shipping from outside the United States please use this label. RMA NUMBER Ship to: Selected Broker: Kavlico Returns C/O Dora Paz 1461 Lawrence Dr. Fedex Trade Networks Thousand Oaks, CA 91320 19601 Hamilton Ave. United States of America Torrance CA 90502 Phone: 310-353-3347 Fax: 310-353-3216 E-mail: [email protected]

AF194 REV. G:08/2015 THESE COMMODITIES, TECHNOLOGY OR SOFTWARE IF EXPORTED FROM THE UNITED STATES MUST BE IN ACCORDANCE WITH THE EXPORT ADMINISTRATION REGULATIONS. DIVERSION CONTRARY TO U.S. LAW IS PROHIBITED.