RMA Submission Form Name First Last Phone No. Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country Name of and Place where Firearm Purchased* Original Owner?* YesNo Model Number* Serial Number* Brand of Mag Used (ex. Promag, Xtech, P-mag, etc)* Brand of Ammunition Used* Total approximate rounds fired to date, prior to experiencing issues* Experienced Failure to Fire?* YesNo Experienced Failure to Feed round into chamber?* YesNo Experienced Failure to extract empty casing out of barrel?* YesNo Experienced Failure to Eject empty casing out of rifle?* YesNo Provide Explanation of Problem Upload Photo of Problem when Possible