SRA Form for
BROTHER
Brand *
BROTHER
CHECKLIST
PLEASE DO NOT INCLUDE ACCESSORIES
(remote, power cord, mic, etc.)
PREFERRED CARRIERS
FEDEX or UPS
In Warranty?
In Warranty
Out of Warranty
Model *
--Select a Model--
* Other
FAX2840
FAX885MC
HL-2140
HL-3075CW
HL-3140CW
HL-L2320D
MFC-665CW
MFC-7365DN
MFC-9325CW
MFC-9970CDW
MFC-J4410DW
MFC-J4710DW
MFC-J6710DW
MFC-J985DW
MFC-L2750DW
MFC-L8850CDW
MFC-L8900CDW
Serial Number *
RMA Number
Purchase Date
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Select a State
Alberta
Alabama
Alaska
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
Newfoundland and Labrador
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Other
Zip *
Email Address *
Primary Phone *
Reason for Repair *
Save Original Box
(Note: If a box is deemed unsafe per carrier specifications, an additional fee will be charged with material costs to return your product)
Method of sending unit ?
DropOff
To Be Shipped
Method of return ?
PickUp
To Be Shipped
I have read the
Terms and Conditions