Sample Request Form v2.1

ADATA NA Sample Request Form v2.1

Step 1: Request Info

Request Type Lending Period Request by Sales Group
Sample Purpose Reason Code

Step 1a: SI / IA Project Only

Begin Date Project Application Competitor Price Info Confident Rate HQ Test before Ship

Step 2: Customer Info

**NOTE**
1) LA Marketing #13989 is NO LONGER VALID
2) CANNOT use code #1002 for Lending Samples. You MUST have a BILL TO account created before applying request.
3) For FREE samples, you MAY use code #1002 for new customers, but limited to ONE TIME ONLY.
4) Marketing lending sample, please use internal lending process.
Customer Code Ship to Address (If Different than Customer Code) Monthly Forecast
Special Instruction

Step 3: Add Line Items


Model PN Quantity Action
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*Free Sample:
Amount $1-$200: SM approval | amount $201-$400: MD approval | amount over $401-3,000: GM | amount over $3,001: President approval
*Lending Sample:
Amount $1-$500: SM approval | amount $501-$1,500: MD approval | amount over $1,501-5,000: GM | amount over $5,001: President approval
*Any shipping upgrade: MD approval

Note:
1. This standard also applies to the approval amount for internal borrowing applications.
2. If the reason for internal borrowing materials is RMA demand, there is no amount limit. And only SM’s approval will be required.
3. Free sample and lending sample cancellation: SM e-mail approval