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Please provide substantiating photos or supporting material of the malfunction. Failure to complete this form in its entirety AND provide substantiating evidence will result in the denial of the parts warranty claim. The damaged part MUST be returned to OMER USA, Inc., 3404 Oakcliff Rd., Suite C4-C6, Atlanta, GA 30340, at the Equipment Owner’s cost after the repair is completed to receive reimbursement.