Note: This form has to be printed and sent with shipment for credits to even be processed!!

Return Sheet

Company Name *

Company Name

Contact Name *

Contact Name

Company City Location *

Email *

Contact Phone Number *

Your RGA#

1 Part Number *

Quantity *

Invoice Number *

Original PO Number *

2 Part Number

Quantity

Invoice Number

Original PO Number

3 Part Number

Quantity

Invoice Number

Original PO Number

4 Part Number

Quantity

Invoice Number

Original PO Number

5 Part Number

Quantity

Invoice Number

Original PO Number

6 Part Number

Quantity

Invoice Number

Original PO Number

7 Part Number

Quantity

Invoice Number

Original PO Number

8 Part Number

Quantity

Invoice Number

Original PO Number

9 Part Number

Quantity

Invoice Number

Original PO Number

10 Part Number

Quantity

Invoice Number

Original PO Number

Is this a New Return * Yes No

Reason for return * Customer never picked up Incorrect part number ordered Non movement item ( Restocking Fee) Non movement item ( 2 for1 restock replacement) Core Return Other Reason for return

Is there a Warranty included in this return * No If yes what is the part # Is there a Warranty included in this return

Additional Warranty item No If yes what is the part # Additional Warranty item

Additional Warranty item No If yes what is the part # Additional Warranty item

Additional Warranty item No If yes what is the part # Additional Warranty item

How many total units

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