To expedite our Return Authorization service, please fill out the below form and click to �Submit�. The fields marked by an asterisk ( * ) are mandatory.

After you click 'Submit', you will receive your RA number . The RA Number must appear on all related correspondence, shipping papers, and invoices.

Kindly read our Terms and Conditions of Sale.
 
 
Company Name:  
*Customer Contact:  
*Billing Address:  
*City :  
*State/Province :  
*Zip:  
*Phone:  
*Customer E-mail :  
 Fax:  
 

 

   *

 Buyer:

 

Original PO#

Original SO#

 Replacement SO#
 

*ORIGINAL INVOICE TERMS:

 

*REFUND CREDIT TO BE MADE VIA:

 
You must enter at least on item.
 
* ITEM # * DESCRIPTION Opened * REASON FOR RETURN * QTY * UNIT PRICE *TOTAL  
          *  
* *    * * *
* * * * * *
* * * * * *
* * * * * *
* * * * * *
* * * * * *
* * * * * *
* * * * * *
* * * * * *
 

*Salesperson

 

*Return to Vendor for Credit ?

  

*Location/Office

    
 
Comment :

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