Return & Shipping Intake Form

Please fill out the information below in order to start the return request process.

Company Name(Required)

Name(Required)

First Last

Email(Required)

Phone(Required)

Return Shipping Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Account Method(Required)

Please specify your preferred shipping carrier. NOTE: Amphenol Ardent Concepts ships Ground for domestic shipments unless otherwise specified.

DHL

FedEx

UPS

Other

If you answered "Other" above, please specify:

Shipping Account Number(Required)

Part Number(Required)

If unsure, please type "N/A"

Serial Number(Required)

If unsure, please type "N/A"

Quantity(Required)

Reason for Product Return(Required)

Please upload any relevant files and/or images

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 128 MB, Max. files: 5.

Amphenol Ardent Concepts

US Patent Numbers 6,787,709, 6,909,056, 7,126,062, 7,556,503. Other US and Foreign Patents Pending