BIOTECH RETURN FORM RETURN GOODS AUTHORIZATION AND FEEDBACK A Printable version is found at the end of this document. Date MM slash DD slash YYYY Biotech Case Number: SECTION 1Customer Name(Required) Customer Number Name First Last Email(Required) Phone(Required)Returned ItemPart NumberQuantityLOT ID or S/NReason for return Add RemoveSECTION 2 — Information of cost. For return of a non warranty article Biotech will charge a troubleshooting fee of 100 USD. For warranty article that is proven to work when Biotech test it, Biotech will charge a troubleshooting fee of 100 USD. SECTION 3 — Hazard Free Certification for Product Return The product(s) has been fully rinsed and flushed clean of residual chemicals, solvents and buffers. The Product(s) has never been used with any hazardous, corrosive or radioactive materal, including, without limitation, Hexafluroisopropanol (HFIP), infectious, or microbiological substances and any other material that may be hazardous to human health or safety, or in any system or process involving the use of any such material. Recommended shipping solvents are ethanol or iso-propanol (pure solvents or mixtures with water) Listed below is a full, accurate and complete list of all chemicals, solvents and buffers that have been used with the Product(s) or in any system or process in which the product(s) has been used. Type of Chemical, Solvent or BufferName Responsible for Hazfree Cert. Name Title Signature (printed version) Biotech AB is very concerned about your privacy. We only collect data for the following purposes: analytics, contacting the user, managing orders, managing contacts and sending messages. Read our Privacy Policy here.Please confirm(Required) Yes, I have read and accepted Biotech's Privacy Policy. If you prefer, you can download this form as a pdf which you can print and send to Biotech. Download pdfCAPTCHA