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RMA Request Form

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Case # / Service Request #
General Information
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Customer’s Ship To
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Bill To
/ Freight Terms:
Customer: / Customer: / Check If Same as Ship To or Complete Below / Partial Shipment: Yes No
In Warranty – Customer Responsible
for In bound Freight, and ViaSat is responsible for return.
Out of Warranty – Customer responsible in-bound and return.
For Out of Warranty: Provide Preferred Carrier, Level of Service& Account #
Preferred Carrier & Instructions (for Out of Warranty only):
Requestor: / Contact: / Customer:
Address: / Contact:
Phone: / Address:
Fax: / City:
E-Mail: / State/Province: / City:
Date: / Zip/Postal Code: / State/Province:
Country: / Zip/Postal Code:
Return DoDAAC Acct. # ______/ Phone: / Country:
COMSEC Acct. ______/ Site ID#:
Part Number
(actual part number of part being returned) / Model / Part / Rev / S/W Version Description / Serial No. / Failure Symptoms
(Please note any physical damage and attach sheet if you need additional space / WarrantyStatus

(ViaSat UseOnly)

IN OUT / Country of Origin / Repair Price
(ViaSat Use Only) / Original Sales
Order # /
Contract #/ SR#
(ViaSat Use Only)
Commercial Aviation Products (only) / FAA Drug & Alcohol Program Required: Yes No / FAA 8130-3 Required: Yes No
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Customer Name:

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All Customers:

  • Please note Customer shall indicate in the Version Description column above, what software is in unit being returned. If a software upgrade or different version is required it should be noted in the Failure Symptoms column, above.
  • Out of Warranty – if you have an open account with ViaSat, a purchase ordermust be submitted after receipt of repair quote.
  • Out of Warranty – cash in advance accounts must pay via MasterCard, Visa, AMEX or wire payment to: Union Bank, 530 “B” Street, San Diego, CA 92101-4407; ABA# 122000496 Account of: ViaSat, Inc. Account # 4000142625, Switch ID# BOFCUS33MPK.
  • Out of Warranty - Standard ViaSat Terms and Conditions will apply. Payment is due prior to start of repair.
  • Out of Warranty – Test Teardown &Evaluation (TT&E) payment due prior to start of repair

International Customers:

  • Please forward a copy of Customer Invoice, Airway Bill and Export Permit to your Customer Service Representative.
  • A copy of your Commercial Invoice needs to be included with your Freight
  • RMA Number must be listed on Commercial Invoice, Airway Bill and Boxed Equipment

Please add the following information to your company issued export documents (Commercial/Pro forma Invoice and air waybill) to ensure ViaSat accurately declares information to U.S. Customs:

  • Add the tariff codes/country of origin and unit value to each line item as identified

“Wood packing materials used for pallets and crates must be treated and marked to comply with U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS). For further information, see the APHIS web site at .

Please add the following applicable Notify Party (Intermediate Consignee) to the Commercial or Pro Forma Invoice and Air Waybill If AIR FREIGHT is used to enable ViaSat to facilitate US customs clearance correctly and promptly.

Shipping Instructions – NON ITAR

Notify Party (Intermediate Consignee) for
ViaSat – Carlsbad, California Destination / Notify Party (Intermediate Consignee)
ViaSat – Duluth, Georgia Destination
Tigers (USA) Global Logistics, Inc.
Attn: Jane Vanbeek/Gerry Tilton
390 W. Manville Street
Compton, CA 90220, United States
Tel: + 1 310-727-1700
Email:
and / Dachser USA
Attn: Eugene Pluta
575 Forest Parkway, Suite G,
College Park, Georgia 30349, United States
Tel: +1 (770) 991-7555
Email: ”

If this shipment is governed under ITAR regulations for Import/Export:

  • Place the following statement on your commercial invoice:

**** THIS SHIPMENT IS BEING IMPORTED IN ACCORDANCE WITH AND UNDER THE AUTHORITY OF 22 CFR 123.4(a)(1)****

  • On the Airway Bill, please check Broker Selection:
  • Tigers (USA) Global Logistics, Inc. Attn: Jane Vanbeek/Gerry Tilton
  • Place a copy of this RMA Form with your shipment

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Customer Name:

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Shipping Instructions – ITAR

Please ship via air freight only and add one of the following applicable Notify Party (Intermediate Consignee) to the Commercial / Pro Forma Invoice and Air waybill. Please do not use international courier services (e.g. DHL, FedEx, UPS) for ITAR controlled items.

Notify Party (Intermediate Consignee) for
ViaSat – Carlsbad, California Destination / Notify Party (Intermediate Consignee)
ViaSat – Duluth, Georgia Destination
Tigers (USA) Global Logistics, Inc.
Attn: Jane Vanbeek/Gerry Tilton
390 W. Manville Street
Compton, CA 90220, United States
Tel: + 1 310-727-1700
Email:
and / Dachser USA
Attn: Eugene Pluta
575 Forest Parkway, Suite G,
College Park, Georgia 30349, United States
Tel: +1 (770) 991-7555
Email: ”

If this shipment is governed under COMSEC/ DoDAAC regulations please follow these Important Instructions:

  • Please print this form & enclose it in your shipment along with an SF-153 or any other necessary forms.
  • COMSEC or DoDAAC Information: please provide valid Communications Security (COMSEC) account information or valid DoDAAC account information which consists of the following:
  • Provide a DoDAAC Supply account when shipping to an Army or Air Force Base and include the following information:
  • Six digit DoDAAC account
  • DoDAAC Point of Contact (POC)
  • A phone number for the DoDAAC POC
  • Provide a NSA COMSEC account when shipping to somewhere other than an Army or Air Force Base and include the following information:
  1. Six digit COMSEC account
  2. COMSEC Custodian’s name
  3. A phone number for the COMSEC Custodian
  4. A corresponding address for the COMSEC account
  • Government Prime Contract Number: please provide the government prime contract number that the COMSEC equipment is in support of. If the COMSEC equipment is not in support of a prime contract, please provide a brief explanation of the intended use of the equipment.

Please complete form and E-Mail to: or FAX to 760-602-5696. Upon acceptance of request an RMA Acknowledgement will be processed and forwarded with shipping instruction.

PR001388 Rev 009 (5/30/13)Page 1 of 3