RA Request Form

Used by URC's direct dealers to facilitate returns on defective product.

Complete this form in detail and submit to URC for approval:

This Return Authorization (RA) request form is used by URC's direct dealers to facilitate returns on defective product. This form is required to be submitted for each return, although multiple products (up to 20) may be placed on a single submission.

For questions about the return process please call 914.705.4141.

IMPORTANT: You must describe the specific defect in the space(s) provided below. Without a detailed description, no RA will be issued. All products should have a case number provided by Technical Support before an RA number is generated or before the unit is mailed in. Products returned for replacement or credit must include all original accessories and packaging. Please make sure units are placed in a sturdy carton. List only one item per line and note serial number.

WARNING: Products returned without a case number will be returned to sender without notification if no defect is found. All programming is lost when remotes are replaced unless you save the program file prior to mailing in your remote. All products are subject for rejection without notifying the dealer if no defect and/or case number is provided.

* Required fields

Dealer Name*:
Account Number*:
Contact Person*:
Phone Number*:
Contact Person Email*:
Case or RTD Number:
Billing Address
Address Line 1*:
Address Line 2:
ZIP Code*:
Ship To Address (if different from billing)
Address Line 1:
Address Line 2:
ZIP Code:


Unit #1
Model #*:
Serial #*:
Purchase Date*:
Warranty Status (Y or N)*:
Adv. Replacement (Y or N)*:
MAC ID (if applicable):
iOS Setup Code (if applicable):
Specific Defect and
Symptoms of Malfunction:
Add Another Unit

Upload your Invoice (optional):

Captcha image

Can't read the image? Click here to refresh.